Megaloblastic anemia: what is it?
There are many types of anemia (anemia), each of which are caused by different reasons. One of the types of this disease is megaloblastic anemia. Consider what is this disease and why it develops.
What is it?
Megaloblastic anemia (synonyms: pernicious, pernicious anemia, megaloblastic, or Addison’s disease) is a violation of hematopoiesis due to the lack of vitamin B12 and (or) of folic acid. The disadvantage of these substances particularly harmful for nerve cells and fibres, and also bone marrow.
With a shortage of vitamin B12 and (or) folic acid failures occur in the formation of DNA and RNA that causes the development of megaloblastic hematopoiesis. In the blood instead of normal red blood cells appear immature progenitor cells – megaloblasts. They can not fully perform the function of red blood cells, resulting in characteristic symptoms.
The causes of the pathological state
Cause of lack of vitamin B12 and (or) folic acid is usually a reduction of absorbability of the stomach lining. It is observed, when disturbed production of protein, which can bind these substances. In what situations is found:
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- older people with atrophy of the gastric mucosa;
- enteritis, hepatitis, history of the patient;
- a few years after the performed surgeries in the stomach, for example after gastrectomy;
- long-term use of medicines that disrupt the work of the gastric mucosa;
- invasion broad tapeworm;
- diverticulosis and cancer of the stomach;
- specific genetic syndrome (hereditary lesion of the gastric mucosa, skin and kidneys);
- constant abuse of alcohol;
- toxic damage of the stomach and.
Lack of folic acid is often observed in pregnant women, weak children and infants children who are on feeding milk goats.
Clinical symptoms and signs
The disease manifests different symptoms. Look at the key manifestations of this pathology:
- sudden weakness, loss of ability to work;
- dizzy, flashing «flies» in the eyes;
- the skin is pale with a yellowish tinge;
- the signs of glossitis (inflammation of tongue): red polished language, dryness, pain and sore mouth;
- disruption of the gastrointestinal tract: bloating, flatulence, problems with a chair, a feeling of heaviness and epigastric pain;
- the size of the liver and spleen above the norm;
- irritability, convulsions, hallucinations.
- signs of funicular myelosis. It is a disease of the spinal cord, in which there is degeneration of posterior and lateral cords. It is characterized by pain in the legs, paresis, loss of sensitivity, a disorder of the pelvic organs, etc.
Blood test this type of anemia is manifested as follows: found megalocytes (large red cells larger than 12 µm in diameter), megaloblasts, and it’s bleeding the other cells. The number of leukocytes and platelets decreased. There is an increase in the size of cells red and white group.
How to diagnose?
A key role in the diagnosis plays a bone marrow puncture. When it detects an increase in erythroid up to 90% due to the growth of megaloblasts.
Important! To puncture is necessary before treatment with vitamin B12, megaloblasts otherwise may be lost after his first injections.
In situations of differential diagnosis eritromitinom (cancer of red blood) watch the number of megaloblasts. In pernicious anemia, they disappear after a B12 injection, and for cancer of the blood, their number does not change even after the full course of treatment with this vitamin.
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Principles of treatment
Therapy of this disease starts with administration of vitamin B12. Parallel to treat the reasons that caused this condition. So, when the parasite worms administered de-worming therapy. The patient was advised to stop alcohol consumption and diet, to calm irritated mucous membranes of the stomach and fix it.
Vitamin B12 is assigned every day subcutaneously in certain dosages for 6 weeks. After the blood counts normalized, treatment continued for another 3 months once a week, and then for half a year, 2 times in a month taking the vitamin. Dosage and the exact course of treatment depends on the blood parameters and are selected by the attending physician individually.
Along with the usually prescribed vitamin B12 and folic acid. For prevention it is recommended to take a few months before planning of pregnancy and whole first trimester of pregnancy. If the patient has a severe degree of anemia observed signals prekomatosnoe state or a coma, he performed red blood cell transfusions in the course of several treatments.