Pernicious anemia is a violation of the red blood of the hematopoiesis caused by a deficiency in the body of cyanocobalamin (vitamin B12). With B12-deficiency anemia, circulatory-hypoxic (pallor, tachycardia, dyspnea), gastroenterological (glossitis, stomatitis, hepatomegaly, gastroenterocolitis) and neurologic syndromes (sensitivity disorder, polyneuritis, ataxia) develop. Confirmation of pernicious anemia is made according to the results of laboratory studies (clinical and biochemical analysis of blood, punctate bone marrow). Treatment of pernicious anemia includes a balanced diet, intramuscular injection of cyanocobalamin.
Causes of pernicious anemia
The daily human need for vitamin B12 is 1-5 μg. It is satisfied by the intake of vitamin with food (meat, fermented milk products). In the stomach under the action of enzymes, vitamin B12 is separated from the food protein, but for assimilation and absorption into the blood it must connect to the glycoprotein (Castle factor) or other binding factors. The absorption of cyanocobalamin into the bloodstream occurs in the middle and lower parts of the ileum. The subsequent transport of vitamin B12 to tissues and hematopoietic cells is carried out by blood plasma proteins transcobalamines 1, 2, 3.
The development of B12-deficient anemia can be associated with two groups of factors; nutritional and endogenous. Alimentary reasons are caused by insufficient intake of vitamin B12 with food. This can occur during starvation, vegetarianism and diets with the exception of animal protein.
Treatment of pernicious anemia
The diagnosis of pernicious anemia means that the patient will need lifelong pathogenetic treatment with vitamin B12. In addition, a regular (every 5 years) gastroscopy is performed to exclude the development of stomach cancer.
In order to fill the deficit of cyanocobalamin, intramuscular injections of vitamin B12 are prescribed. Correction of the conditions leading to B12-deficiency anemia (de-worming, taking enzyme preparations, surgical treatment) is required, and in case of alimentary nature of the disease a diet with a high content of animal protein. If the development of the internal factor of the Castle is impaired, glucocorticoids are prescribed. To hemotransfusions resorted only to severe anemia or signs of anemic coma.