Pernicious Anemia
What is Pernicious Anemia?
Pernicosis anemia is a condition in which the body does not have enough vitamin B12 and not enough healthy red blood cells can be made.
Vitamin B12 is a nutrient found in certain foods. In order for the body to produce healthy red blood cells and the nervous system to function properly, this vitamin is needed.
Patients with pernicious anemia are unable to absorb vitamin B12 to their bodies sufficiently due to the lack of a protein produced in the stomach called intrinsic factor. This leads to vitamin B12 deficiency
Other conditions and factors may also lead to vitamin B12 deficiency. Examples include infections, surgical interventions and nutrition. The term “pernicious anemia teknik is technically a deficiency of vitamin B12 due to the absence of intrinsic factor. Vitamin B12 deficiency, often caused by other causes, is also called pernicious anemia.
Overview
Pernicious anemia is a type of anemia. (Anemia means there are fewer red blood cells in your blood than usual). In pernicious anemia, the body does not have enough vitamin B12 and cannot make enough healthy red blood cells.
If you don't have enough vitamin B12, your red blood cells cannot undergo normal division and become too large. They may have problems transmitting blood from the bone marrow (the spongy tissue in the bones, where blood cells are made).
If you don't have enough red blood cells to carry oxygen to your body, you may feel tired and exhausted. Severe and prolonged pernicious anemia can damage the heart, brain and other organs in the body.
Pernicious anemia can also cause other complications such as nerve damage, neurological problems (such as memory loss) and digestive system problems. In addition, people with pernicious anemia may have an increased risk of developing stomach cancer.
General view
In the past, this condition was called pernicosis (a fatal word) anemia because it often ended in death before vitamin B12 treatment. Today, pernicious anemia can be easily treated with vitamin B12 pills or needles.
With appropriate treatment and ongoing care, most people with pernicious anemia can heal, feel good and live their normal lives.
Without treatment, pernicious anemia can cause serious problems with the heart, nerve and other parts of the body. Some of the effects of this condition can be permanent.
Other Names Given to Pernicious Anemia
Pernicious anemia is one of two major types of anemia, also called “macrocytic” or “megaloblastic emi anemia. These terms refer to anemia in which red blood cells are larger than normal. (Another major type of macrocytic anemia is anemia due to folic acid deficiency.)
Rarely, children are born with an inherited disorder that interferes with the production of intrinsic factor. This disease is called congenital pernicious anemia.
Vitamin B12 deficiency is also called cobalamin deficiency and combined system disease.
What Causes Pernicious Anemia?
Pernicious anemia is caused by a lack of intrinsic factor or other causes such as infection, surgical interventions, medications or nutrition.
Intrinsic Factor Deficiency
Intrinsic factor is a protein in the stomach that helps absorb vitamin B12. In some people, intrinsic factor deficiency is the result of an autoimmune disease.
Autoimmune response occurs when the body's immune system accidentally makes antibodies that attack healthy cells and damages tissues and cells.
In pernicious anemia, the body produces antibodies that attack and destroy parietal cells. These are the cells in the gastric wall that make intrinsic factor. The cause of this autoimmune response is unknown.
As a result of this attack, the stomach stops intrinsic factor production. Without an intrinsic factor, your body cannot absorb vitamin B12 from the small intestine, where it is normally absorbed. This leads to vitamin B12 deficiency
Intrinsic factor deficiency may also occur if all or part of your stomach has been removed. Such operations reduce the number of parietal cells that will perform intrinsic factor production.
Rarely, children are born with an inherited disorder that interferes with the production of intrinsic factor. This disease is called congenital pernicious anemia.
Other Causes
In addition to intrinsic factor deficiency, other conditions and factors may also cause pernicious anemia.
Impaired Absorption from Small Intestine:
Sometimes pernicious anemia can occur because vitamin B12 is not absorbed well from the small intestine. The reasons for this may be:
The wrong kind of bacteria in the small intestine is too many. This is a common cause of pernicious anemia in adults. Bacteria consume vitamin B12 before being absorbed from the small intestine.
Diseases that disrupt the absorption of vitamin B12. An example is celiac disease. This is a genetic disorder in which your body cannot tolerate a protein called gluten. Another example is Crohn's disease. Crohn is an inflammatory bowel disease.
Some drugs that prevent the absorption of vitamin B12 from the small intestine or affect the growth of bacteria. Examples of these drugs are antibiotics and some epileptic drugs.
Surgical removal of all or part of the small intestine.
Intestinal worms. The intestinal worm can feed on vitamin B12 and consume it. Eating fish that is not adequately cooked or infected can cause this type of infection.
Nutrition:
Rarely, some people may develop pernicious anemia because they do not get enough vitamin B12 with food. The richest sources of vitamin B12 are meat, poultry, fish, eggs and dairy products. You can also take vitamin B12 with nutritional supplements.
In strict vegetarians who do not consume any meat or dairy products and do not take vitamin B12 supplements, the risk of pernicious anemia increases.
Children who are breastfed by mothers who are fully vegetarians are at increased risk for pernicious anemia. These babies may develop anemia within months after birth. This is because they do not have enough time to store vitamin B12 in their bodies. Doctors treat these babies with vitamin B12 supplements.
People in other groups, such as the elderly or alcoholics, may also be at risk of pernicious anemia, as they may not be able to get enough vitamin B12 by feeding.
Who is at Risk for Pernicious Anemia?
Pernicious anemia is most common in people of Northern European and African descent.
Older people in the United States are at greater risk. This is due to a lack of gastric acid and intrinsic factor. The lack of these prevents the absorption of vitamin B12 from the small intestine. As people age, they tend to produce less stomach acid.
Pernicious anemia may also occur in younger individuals and other population groups. If the following factors apply to you, your risk of pernicious anemia is increased:
If there is someone in your family who is in this situation.
All or part of your stomach is removed by stomach surgery. Stomach vitamin B12 produces an internex factor, a protein that helps absorption.
If you have an autoimmune disease involving endocrine glands such as Addison's disease, type 1 diabetes, Graves' Disease and vitiligo. According to studies, there may be a connection between these autoimmune disorders and pernicious anemia caused by autoimmune response.
If all or part of your small intestine was removed by surgery. Small intestines are where vitamin B12 is absorbed.
If you have a bowel disease or disorder that prevents the absorption of vitamin B12. Examples include Crohn's disease and intestinal infections.
If you use drugs that prevent the absorption of vitamin B12 in your body. Examples of these drugs are antibiotics and some epileptic drugs.
If you are a full vegetarian who does not consume any meat or dairy products and does not take vitamin B12 supplements, or you usually eat less meat.
What are the signs and symptoms of pernicious anemia?
Signs and symptoms of pernicious anemia are due to vitamin B12 deficiency (vitamin B12 deficiency). If vitamin B12 is not enough, your body cannot produce as many healthy red blood cells as necessary. This causes anemia.
Some signs and symptoms of pernicious anemia can be seen in all types of anemia. Other signs and symptoms are specific for vitamin B12 deficiency.
Signs and Symptoms of Anemia
The most common symptom in all types of anemia is fatigue and fatigue. This symptom is caused by a lack of enough red blood cells to carry oxygen to various parts of your body.
Low red blood cell count also shortness of breath; dizziness, especially when standing up; headache; coldness of hands or feet; pale skin, gums and nails; and chest pain.
Reduction in red blood cells also means that your heart needs to work harder to distribute oxygen-rich blood to your body. This can lead to arrhythmias, heart murmur, heart enlargement and even heart failure.
Vitamin B12 Deficiency Findings and Symptoms
Deficiency of vitamin B12 can cause nerve damage. This can cause pinning and tingling in your hands and feet, muscle weakness and loss of reflex. You can also stagger, lose balance and have problems walking.
Severe vitamin B12 deficiency can cause neurological problems such as blurred consciousness, dementia and depression.
Other signs of vitamin B12 deficiency are related to the digestive tract. These symptoms include nausea, vomiting, burning sensation in the esophagus, abdominal distension and flatulence, constipation or diarrhea, loss of appetite and weight loss. Liver growth is another symptom.
A smooth, red-colored tongue is also a sign of vitamin B12 deficiency and pernicious anemia.
Infants with vitamin B12 deficiency may develop movements that are not normally seen, such as weakening or tremors in the reflexes. These babies may have nutritional problems due to tongue and throat problems. These babies are also very quickly aroused, they can be constantly uneasy. Untreated vitamin B12 deficiency may cause permanent growth problems in infants.
How is Pernicious Anemia Diagnosed?
Your doctor will diagnose pernicious anemia based on your medical and family history, physical examination and test results.
Your doctor will investigate whether this is due to a lack of intrinsic factor or another cause. He will try to find out how severe the situation is and the reason for it to be treated appropriately.
Experts in the Diagnosis Process
Primary care physicians, such as family physicians, internal medicine specialists or pediatricians, can help diagnose and treat pernicious anemia. Doctors from other disciplines may also be involved:
Neurologist
Cardiologist
Hematologist
Gastroenterologist (digestive system diseases specialist)
Medical Stories and Family Stories
Your doctor may ask you questions about your signs and symptoms: Your doctor may ask:
Whether you've had stomach or intestinal surgery,
Whether there is a digestive system disorder such as Celiac disease or Crohn's disease,
Nutritional style and medications you use,
Whether your family has anemia or pernicious anemia
Whether you have a history of autoimmune disease in your family (such as Addison's disease, type 1 diabetes, or Graves' disease) According to studies, there may be a link between these autoimmune disorders and the pernicious anemia caused by the autoimmune response.
Physical Examination
During the physical examination, your doctor will check whether the skin color is pale or yellowish and that there is growth in the liver. Can listen to your heart to see if you have a fast heartbeat or a murmur in your heart
Your doctor will also check for signs of nerve damage. It will also check if your muscles, eyes, senses and reflexes work well. Your doctor may also ask questions and perform tests to check your mental state, coordination and gait.
Diagnostic Tests and Procedures
Blood tests and procedures may be useful in the diagnosis and understanding of the cause of pernicious anemia.
Whole Blood Count
Generally, the first test for the diagnosis of many types of anemia is complete blood count (also called CBC / TKS / hemogram). Many parts of your blood are measured on the hemogram. For this test, a small amount of blood will be drawn by a needle into your vein, usually from your arm.
This test measures your hemoglobin and hematocrit values. Hemoglobin is an iron-rich protein in the red blood cells that carries oxygen to the body. Hemotocrit is a measure of the volumetric ratio of red blood cells in the blood. Low hemoglobin or hemotocrit is a sign of anemia.
The normal values of these measurements vary depending on race and population. Your doctor may explain the test results to you.
The hemogram also looks at the number of red blood cells, white blood cells and platelets in your blood. Abnormal results may be indicative of anemia, another blood disease, infection, or other condition.
The mean corpuscular volume (MCV) of the red blood cells is also measured on the hemogram. MCV is a measure of the average size of your red blood cells. This measurement can give a clue about the cause of your anemia. In pernicious anemia, red blood cells are larger than normal (macrocytic).
Other Blood Tests
If your hemogram shows that you have anemia, you may need to take some other tests to investigate the type of your anemia.
The reticulocyte count measures the amount of young red blood cells in your blood. This test indicates whether the bone marrow produces red blood cells at the correct rate. The number of reticulocytes is low in people with pernicious anemia.
Serum folate, iron, and iron binding capacity tests may also be useful to determine if you have pernicious anemia or any other type of anemia.
Your doctor may also require further blood tests to investigate the following conditions:
Low vitamin B12 levels in your blood indicate that pernicious anemia.
Homocysteine and methylmalonic acid (MMA) levels. High levels of these substances in your body are symptoms of pernicious anemia.
Intrinsic factor antibodies and parietal cell antibodies. These antibodies are also a symptom of pernicious anemia.
Bone Marrow Tests
Bone marrow tests show whether your bone marrow is healthy and has enough red blood cells. There are two types of bone marrow tests: aspiration and biopsy.
During the aspiration process, your doctor takes a small amount of fluid from your bone marrow with a needle. For a biopsy, your doctor will remove a small amount of tissue from your bone marrow with a needle. This tissue sample is then examined under a microscope.
In pernicious anemia, red blood cells are larger than normal (macrocytic).
How is Pernicious Anemia Treated?
Doctors treat pernicious anemia by replacing the missing vitamin B12 in your body. People with pernicious anemia may need lifelong treatment.
Objectives of Treatment
Some of the objectives of the treatment of pernicious anemia:
Prevent or treat anemia with signs and symptoms of anemia
Prevention or control of complications such as heart and nerve damage
To treat the cause of pernicious anemia (if found)
Special Treatment Types
Pernicious anemia is usually easily treated with vitamin B12 pills or needles.
If you have a severe pernicious anemia, your doctor may recommend needle therapy first. Needles are usually made from the hip every day or every week until the vitamin B12 level in your body increases. Once the vitamin B12 value in your blood has returned to normal, you may be injected once a month.
For milder pernicious anemia, your doctor may prescribe high doses of vitamin B12 pills. Nasal gel and spray containing vitamin B12 is also available. These products can be useful for people who have difficulty swallowing pills, such as the elderly or stroke sufferers.
Your signs and symptoms may begin to improve within a day or two of treatment. Your doctor may recommend that you limit your physical activity until your condition improves.
If you have an anemia other than intrinsic factor deficiency or a factor-related pernicious anemia, you may also need treatment for it.
For example, medications can be used to treat conditions that prevent your body from absorbing vitamin B12. Your doctor may change the type or dose of medication if the medications you use cause pernicious anemia. Babies of mothers who are fully vegetarian can be given vitamin B12 supplements from birth.
How can pernicious anemia be prevented?
Pernicious anemia due to intrinsic factor deficiency cannot be prevented. Without intrinsic factor, your body cannot absorb vitamin B12, which leads to pernicious anemia.
Rarely, some people may develop pernicious anemia because of insufficient vitamin B12 intake. You can take some precautions to prevent pernicious anemia due to nutritional factors.
Eating foods rich in vitamin B12 may be helpful in preventing the reduction of vitamin B12 levels. Foods that supply vitamin B12 include:
Meats such as red meat, liver, poultry and fish
Fish and shellfish
Eggs and dairy products (such as milk, yogurt and cheese)
Breakfast cereals and other vitamin B12-added foods
Vitamin B12 is also found in multivitamins and B complex vitamin supplements. Doctors may recommend supplements for those at risk of vitamin B12 deficiency, such as those who are fully vegetarian or have undergone stomach surgery.
Elderly may have problems in absorbing vitamin B12. Therefore, doctors may recommend that older adults eat foods enriched with vitamin B12 or take vitamin B12 supplements.
Living with Pernicious Anemia
With appropriate treatment, people with pernicious anemia can heal, feel good and live their normal lives.
If complications of pernicious anemia such as nerve damage have occurred, early treatment may help to heal the damage.
Continuous Maintenance
If you have pernicious anemia, you may need lifelong treatment with vitamin B12. You should see your doctor regularly for checks and continuous treatment. Take vitamin B12 supplements as instructed by your doctor. It may be helpful in preventing these symptoms and complications.
During your follow-up, your doctor will check for signs of vitamin B12 deficiency. Your doctor may re-arrange your treatment as needed.
If you have pernicious anemia, you have a higher risk of developing stomach cancer. You should see your doctor regularly to check for this complication.
Also, tell other family members, especially your children and siblings, that you have pernicious anemia. Pernicious anemia may be hereditary, so the risk of developing this condition may be greater in these people.
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