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Hassan Mohammad Al-Shehri ID#2051040006
SCHILLING TEST
INDICATIONS
● Rule out pernicious anemia● Identify malabsorption syndrome unrelated to IF deficiency●Dual label Shilling test for pancreatic exocrine function
RADIOPHARMACEUTICAL
● *Co-B
12
for first stage of test● *Co-B
12
+ Intrinsic Factor Capsule for second stage
PROCEDURE
STAGE 1● *Co-B
12
capsule given orally, followed by IM injection of 1 mg nonradioactive VitaminB
12
. This non-radioactive Vitamine B
12
is given to block B
12
binding sites in the liver. If notadministered, essentially all the radioactive B
12
localizes in the liver and little or none isexcreted in the urine, invalidating the test.● Competent 24 hr urine collection● Determination of % excretion in urine.● If normal value obtained (>10%), test completed; no further action required.STAGE 2● If excretion from Part 1 Schilling Test is < 6%, then 3-5 days later another capsule of *Co-B
12
is administered orally along with a capsule containing 1 NF unit of Intrinsic Factor ● This capsule is then followed by IM injection of 1 mg non-radioactive Vitamin B
12
.● Another competent 24 hr urine collection is then performed by patient and % excretion inurine is determined.
INTERPRETATION:
 
% ExcretionPart 1Part 2Interpretation
>10-----Normal<6<6Malabsorption Syndrome unrelated to intrinsic factor <66-12 Pernicious Anemia
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