B12-deficiency anemia is a rather dangerous disease, which is associated with a violation of normal hematopoietic processes that occur against the background of cobalamin deficiency in the body. Today, many people are interested in questions about what factors develop anemia and what symptoms accompany the disease.
What is a disease?
In fact, B12-deficiency anemia is known by various terms - it is percinious or megaloblastic anemia, pernicious anemia, and Addison-Birmer disease. A similar disease is accompanied by a decrease in the number of red blood cells, which is associated with a deficiency of vitamin B12 (cyanocobalamin). It should be noted that not only bone marrow structures are especially sensitive to the lack of this substance, but also nervous tissues, which, in fact, makes the disease extremely dangerous.
In most cases, patients are diagnosed with B12-folate deficiency anemia, in which there is also a lack of folic acid. Firstthe symptoms of the disease were described relatively recently - in 1855, the English physician T. Addison was researching an unknown ailment. And already in 1926, researchers W. Murphy, J. Will and J. Minot noted in their studies that the symptoms of the disease disappear if raw liver is introduced into the patient's diet.
Main causes of B12 deficiency anemia
Immediately it should be noted that there are many reasons for the development of this type of anemia. Some of them are related to the way of life, while others are related to changes in the body itself.
- First of all, we need to mention the so-called alimentary deficiency, which develops as a result of insufficient intake of a vitamin in the body along with food. For example, such a disease can develop against the background of starvation or strict vegetarianism. In an infant, this form of anemia is observed if the nursing mother refuses animal products.
- Some patients experience malabsorption of cyanocobalamin.
- The causes of B12-deficiency anemia may lie in the lack of the so-called intrinsic factor of Castle. This specific complex substance, which is secreted by the intestinal mucosa, combines with cyanocobalamin and ensures its absorption. In turn, the deficiency of this substance can be caused by some congenital anomalies, as well as autoimmune diseases. In addition, the lack of the Castle factor is observed with various structural changes in the stomach, for example, with gastritis, surgicaloperations, etc.
- Risk factors can also include various changes in the structure of intestinal tissues, which is observed in the presence of tumors or develops as a result of surgical excision of part of the intestine.
- Intestinal absorption functions may change in the presence of dysbacteriosis, in which the composition of the microflora changes.
- In some cases, cyanocobalamin, which enters the body with food, is absorbed by other "inhabitants" of the digestive system, such as pathogenic bacteria or worms.
- Risk factors include diseases of the liver and kidneys, as against their background there is often an increase in the release of vitamin B12 or its incomplete use.
- Deficiency can also develop if tissues or organs absorb too much of the vitamin. A similar phenomenon is observed, for example, in the presence of a rapidly growing malignant tumor. Risk factors include hormonal changes and some diseases of the endocrine system, as well as pathologies associated with the active death of red blood cells.
Pathogenesis of disease
How does B12 deficiency anemia develop? The pathogenesis of the disease is directly related to the main functions of cyanocobalamin. This vitamin plays an important role in the process of hematopoiesis. Its deficiency results in a condition known as megablastosis. It is accompanied by the accumulation of large forms of platelets and leukocytes, as well as their premature destruction in the bone marrow.
In addition, vitamin B12 isa cofactor in the most important metabolic reactions that are necessary for the vital activity of nerve cells. That is why the nervous system suffers from its deficiency.
B12-deficiency anemia: symptoms of the disease
Such a disease is accompanied by a mass of symptoms, which are usually combined into three main groups.
To begin with, it is worth talking about the anemic syndrome, which develops against the background of a decrease in the number of red blood cells. At first, patients complain of severe weakness, rapid fatigue and a noticeable decrease in performance. As the disease progresses, intermittent tinnitus is observed, as well as dizziness, and often fainting. Sick people also note the appearance of "flies" before their eyes. Signs of anemia can also include increased heart rate and severe shortness of breath, which occur even with the slightest physical exertion. Sometimes there are unpleasant, stabbing pains in the chest area.
Of course, with a vitamin deficiency, disorders of the digestive system are also observed. In particular, patients experience a sharp decrease in appetite and, as a result, loss of body weight. Periodically occurring nausea and vomiting also bring a lot of inconvenience to a person's life. In addition, stool disorders are also possible - most often these are prolonged constipation. Changes in the tongue are also considered very characteristic, the surface of which is smoothed out and acquires a bright red, and sometimes crimson hue.
Of course it isfar from all the changes that accompany B12 deficiency anemia. Symptoms also appear in the nervous system. First of all, damage to the peripheral nerves is observed. Patients report an unpleasant tingling in the arms and legs, as well as temporary numbness of the extremities. Gradually, muscle weakness develops. Due to the stiffness of the legs, there is a gradual change in gait - it becomes more unstable.
Prolonged deficiency of vitamin B12 leads to damage to the spinal cord, and then the brain. The symptoms of these disorders can vary. For example, damage to the fibers in the spinal cord, as a rule, leads to a loss of sensitivity - a person no longer feels vibrations in the skin (most often the skin on the legs is affected). Some patients develop seizures. But increased irritability, uncontrolled mood changes, color perception disorders indicate brain damage. In the absence of therapy, the patient may fall into a coma.
Disease forms
Of course, there are several schemes for classifying the disease. It is important to know that in modern medicine, B12-deficiency anemia can be of two types, depending on the cause of development:
- The primary form of the disease is usually associated with some genetic characteristics of the organism. This is the type of B12 deficiency anemia most commonly seen in infants.
- The secondary form of the disease develops already in the process of growing up and human life, under the influence of external or internal environmental factors.
Stages of anemia
The main symptoms of the disease directly depend on the stage of its development. The severity of the patient's condition is usually determined based on the number of erythrocytes (red blood cells) in the blood. Depending on this indicator, three stages of the disease are distinguished:
- In mild anemia, the RBC count ranges from 90 to 110 g/L.
- The moderate form is characterized by a more significant decrease in the number of red blood cells - from 90 to 70 g/l.
- If the patient's red blood cell count is 70 g/l or less, then we are talking about a severe form of B120-deficiency anemia, which is extremely dangerous for he alth and even life.
What is the danger of this form of anemia? Possible Complications
Vitamin B12 deficiency anemia can be extremely dangerous if left untreated. As already mentioned, first of all, the lack of this substance affects the state of the nervous system. Complications of this type of anemia include damage to the spinal cord and peripheral nerves. In turn, such violations are accompanied by discomfort and tingling in the limbs, complete and partial loss of sensation, incontinence of feces or urine.
Against the background of a chronic deficiency of cyanocobalamin, the work of the whole organism worsens - various diseases of the kidneys, heart and other organs may appear. Sometimes, against the background of a sharp decrease in the number of red blood cells, cerebral hypoxia develops, which leads to a pernicious coma.
If you start treatment in the early stages, then allthe above complications can be avoided. Late therapy can eliminate vitamin deficiency, but, alas, changes in the nervous system are already irreversible.
Modern diagnostic methods
If you have the above symptoms, you should definitely consult a doctor. After all, only a specialist can accurately determine the disease. To begin with, a medical history is compiled. B12-deficiency anemia most often develops under the influence of certain external factors, so the doctor will definitely take an interest in information about the patient's life, his diet, etc. A physical examination follows. In patients with a similar disease, as a rule, pallor of the skin can be noticed. Often there is a decrease in blood pressure and a rapid heartbeat.
Of course, further studies follow to determine whether B12 deficiency anemia is indeed present. A blood test with a similar disease will demonstrate a decrease in the number of red blood cells and their precursor cells (reticulocytes). Along with this, there is a decrease in the number of platelets. Naturally, the level of hemoglobin in the blood is also reduced. A biochemical blood test can also provide valuable information. With this type of anemia, there is an increase in the level of iron and bilirubin in the blood.
Diagnosis of B12 deficiency anemia includes other procedures. In particular, for laboratory tests, bone marrow is taken (in most cases, a puncture of the sternum is performed). In addition, the patient is testedurine and feces. Electrocardiography, electroencephalography, computed tomography, and sometimes some other procedures are shown - these tests are necessary in order to assess the degree of damage to other organ systems, as well as determine the cause of anemia.
B12-deficiency anemia treatment
A doctor can draw up an effective treatment regimen only after a complete examination of the body. So what kind of therapy does B12 deficiency anemia require? Treatment begins with the elimination of the underlying cause of the disease. For example, in case of helminthic invasion, patients are prescribed antiparasitic drugs, and in the presence of a tumor, surgical intervention.
In addition, it is important to compensate for the deficiency of cyanocobalamin. In the first few days, the vitamin solution is administered intramuscularly. For an adult, the average daily dose is 200 to 500 mcg. In especially severe conditions, the amount of the drug is increased to 1000 mcg - this scheme is followed for three days. Upon reaching stable improvements, the dose is reduced to 100-200 mcg - injections are carried out once a month for 1-2 years.
Naturally, it is extremely important to make the right diet, including foods rich in cyanocobalamin and folic acid, primarily liver, meat and eggs.
Severe degrees of anemia require urgent replenishment of red blood cells. For this purpose, patients are injected with red blood cells isolated from donor blood. The same procedure is necessary for an anemic coma.
According to statistics, the forecast forpatients are quite well. The only exceptions are those cases when a person seeks help in a very serious condition, since it is impossible to restore the affected parts of the nervous system.
Are there effective prevention methods?
As you can see, B12 deficiency anemia is a very dangerous disease. That is why it is much easier to try to avoid it. And in this case, a properly composed diet is very important. Make sure that your menu regularly contains foods rich in cyanocobalamin. In particular, vitamin B12 is found in eggs, meat, liver and dairy products.
All diseases of the gastrointestinal tract should be treated in time - it is extremely important to follow the doctor's recommendations and not refuse the medicines prescribed by him. From time to time, it is recommended to take multivitamin complexes as a preventive measure (once every six months).
After surgery to remove parts of the intestines or stomach, the doctor must prescribe cyanocobalamin preparations in the appropriate dose to the patient.
