Anemia B12 deficiency: symptoms, treatment
B12-palaeodiversity anemia – pathology, in which impaired division of red blood cells that most often develops with a deficit of folate and vitamin called cyanocobalamin (B12). Specified anemia attributed to megaloblastic diseases. It requires prompt treatment, as it is accompanied by the defeat of the national Assembly and is considered to be malignant (pernicious). This article identifies the main causes and manifestations of the disease, describes the basic principles of its therapy.
Causes of B12-deficiency anemia
The lack of B12 in the body is most frequently observed in such cases:
- there is a deficiency in the diet;
- adherence to the principles of vegetarianism;
- insufficient absorption (impaired absorption);
- pathology of the stomach (a condition after gastrectomy, damage to the mucous membranes or the presence of infiltrative changes in the stomach, e.g. lymphoma or carcinoma);
- celiac disease and Crohn’s disease;
- separate resection of the intestine;
- atrophic changes in the stomach;
- diverticula of the intestine;
- worm infestation;
- tuberculosis of the digestive system;
- excessive intake of Neomycin and other drugs;
- the lack of transcobalamin 2 (it is congenital);
- excessive multiplication of bacteria in the intestine that prevent the absorption of vitamin compounds.
Folate deficiency, which also causes B12 deficiency anemia is observed under the following conditions:
- with insufficient it enters the body, what happens when an unbalanced diet, alcoholism and anorexia;
- in poor absorption of folate malabsorbtion, celiac disease, regional eleita, after resection of part of the intestine and the result of taking anticonvulsants;
- when this increased requirement for folic acid that is observed during pregnancy and the presence of concomitant hemolytic anemia, and psoriasis;
- congenital abnormalities of folate metabolism.
In addition, B12-deficiency anemia occurs when deficiency of specific factors of castle. Is an enzyme which converts an inactive form of B12 in one that the body can absorb. Its deficiency usually occurs with the active synthesis of proteins that destroy the cells of the inner layer of the stomach responsible for the production of the said enzyme. Risk factors for the development of the disease is the thoracic and advanced age, the presence of any cancer, hormonal imbalance in the thyroid glands, kidney disease or liver.
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The main symptoms
Cobalamin deficiency manifests itself gradually. The first signs of the disease may appear several years after onset of the disease. In the clinic there are three main syndrome.
1. Anemia associated with impaired hematopoiesis. It is manifested primarily by excessive paleness, and subsequently by yellowness of the skin and mucous membranes. The normal color of the skin is responsible for the hemoglobin, which is a specific protein-pigment coupling and is contained in red blood cells. The development of disease gradually developing pallor, and because of the destruction of red blood cells and entering the blood bilirubin subsequently appears jaundiced.
In addition, B12-anemia is manifested by tachycardia. An elevated heart rate is a compensatory reaction that develops in response to oxygen starvation. The heart has to work harder, which increases a load on it and cause the appearance of pain in the chest, having a prickly nature, extending to the abdomen or radiating to the left shoulder.
Well as patients due to the development of anemia does not tolerate physical activity, as they require increased amounts of oxygen for normal functioning of muscles. That is why even slight physical activity causes fatigue, shortness of breath and dizziness. The patients might have periodic loss of consciousness due to oxygen starvation of the brain.
Disturbed blood supply to the retina. While there is the appearance of spots before the eyes, and worsening of metabolic processes in the vitreous body of the eye leads to a decrease in visual acuity and the appearance of circles in sight.
2. Gastrointestinal syndrome. It is manifested by digestive disorders due to lesions of the mucous membranes. Reduced secretion of specific digestive juices, which in turn leads to insufficient absorption of nutrients. Patients register complaints such as bloating, constipation and diarrhea, heartburn, lack of appetite and weight loss.
B12 deficiency (megaloblastic) anemia is characterized by the discoloration of the tongue. It turns bright crimson, with a smooth surface due to atrophy of papillae. Patients thus complain of taste changes and burning sensation in the mouth. In severe cases register complete loss of taste sensations. Sometimes, you may experience an aversion to certain foods. Also develops glossitis, gingivitis or other infectious processes.
It is also worth noting that the affected mucosa of the stomach. This is manifested by gastritis and development of ulcers on the mucous membrane, accompanied by pain in the abdomen, especially after eating spicy food.
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3. A neurological syndrome. Cobalamin is necessary for the formation of the myelin sheath in the nerve fibers. With its lack of this process is disturbed, which leads to sclerosis and the emergence of various neurological signs. So, patients record the violations of sensitivity, which can be localized in any area of the body, paresthesia (numbness or tingling on the skin), as well as ataxia, which is manifested in uncoordinated movements and impaired balance.
In addition, patients reduced muscle strength. Because of the violation of transmission of nerve impulses occurs their atrophy. Without treatment, these changes lead to paralysis. An unfavorable sign are the mental changes because they indicate damage to the cerebral cortex. Among the most common mental disorders can be called depression, psychosis, and convulsions and hallucinations.
First, we need to eliminate the causes of violations of blood, and to restore the normal functioning of the digestive system and the nervous system. When expressed manifestations of anemia and laboratory-confirmed deficiency of cyanocobalamin carry medication therapy. Usually, vitamin B12 is administered in the form of a solution for intramuscular injection. Admission tableted drugs, but under the condition of normal absorption of vitamins and the absence of neurological disorders.
Minimum course of treatment is 6 weeks. Further supportive therapy (according to indications – for life). To assess the effectiveness of drug therapy patients during treatment twice a week hand over the General analysis of blood. The effectiveness of drugs says the increase in the number of reticulocytes, indicating that the hematopoietic recovery. In severe cases, patients transfused erythrocyte mass.
Without proper treatment, the disease progresses, irreversible changes in the brain, heart and other internal organs, which leads to poor prognosis for patients.