B12 deficiency anemia: the main causes of the disease
Diseases of the blood system develop as a result of hemopoiesis disturbance or predominance of blood destruction, which in turn is reflected in the peripheral blood. B12 deficiency anemia is a disease in which perverted erythropoiesis occurs due to insufficient intake of vitamin B12.This is megaloblastic hyperchromic anemia, in which even with a reduced amount of hemoglobin and red blood cells there will be a high hematocrit. Aplastic anemia also has a similar pattern, but it manifests itself in the form of megalocytosis.
B12 deficiency anemia used to be of a malignant nature, and as a rule, people died from it. But at the present time we have revealed a connection with the content of vitamin B12 in the body, and it is no longer relevant to call it such. For the first time, this anemia was described by Addison in 1855, later supplemented by Burmer in 1868. After that, one can come across under the same name as Addison-Birmer disease.
Etiology and pathogenesis of
Pernicious anemia develops as a result of endogenous impairment, as well as insufficiency of exogenous intake of vitamin B12.With hereditary gastric gland failure, which produce gastromukoprotein, the binding of this vitamin is broken, followed by not sucking it into the gastric mucosa.
As a result of the insufficiency of cyanocobalamin, erythropoiesis is disrupted and it goes by megaloblastic type. As a result, the processes of blood destruction predominate over the processes of hematopoiesis. Reduced amounts of red blood cells are unable to fully provide organs with oxygen, so tissue hypoxia develops.
B12 deficiency anemia - the main causes:
- insufficient intake of vitamin with food;
- the hereditary absence of the Castle factor;
- changes in the gastric mucosa, mechanical damage, once the stomach and atrophic processes;
- gastrectomy;
- colitis, enteritis or helminthic invasion, etc.
Classification of anemia in severity:
- mild - hemoglobin above 90 g / l;
- medium - hemoglobin 90-70 g / l;
- heavy - hemoglobin less than 70 g / l.
Symptoms of the disease
The clinical picture develops slowly, so in the early stages it is diagnosed only by a general blood test.
With the development of the disease, there is weakness, fatigue, dizziness and headaches, shortness of breath, pale skin and icteric sclera, sometimes with lemon yellow tinge, when liver damage has already gone. The tongue is smooth and shiny at the examination, the papillae are atrophied and smoothened, sometimes there is swelling of the papilla or the appearance of wounds on the oral mucosa.
These changes are called Hunter's glossitis. With palpation, you can find an increase in the liver and spleen, and with FGDS - atrophy of the gastric mucosa. Violations of the nervous system are called funikulyarny myelosis, in which the breakdown of nerve fibers in the spinal cord.
Characteristic symptomatology for this: paresthesia, polyneuropathy, loss of sensitivity and strengthening of tendon reflexes. There may be an increase in the lymph nodes.
Treatment of B12 deficiency anemia
How to treat anemia is determined only by a doctor, because everything depends on the cause that causes this disease. With malnutrition, supplements are prescribed in the form of cyanobobalamine, which is absorbed rather quickly, but injections can also be used. The goal of therapy is to saturate the body and maintain the concentration at a constant level. Currently, the administered dose is 500 μg daily.
With organic disorders of the gastric mucosa, in addition to the cyanocobalamin itself, preparations are prescribed that promote regeneration and restoration of the functional capacity of the stomach. In helminthic invasion, antihelminthic agents are added. If a person is given a gastrectomy, he will have to stab vitamin B12 for life.
The effectiveness of treatment is assessed by a general blood test. It should be remembered that at the first signs of malaise you should immediately consult a doctor, and not self-medicate, because irreversible consequences in damage to the nervous system can disrupt your lifestyle!