B12-deficient anemia is a rather dangerous disease, which is associated with a violation of normal blood formation processes that occur against a background of cobalamin deficiency in the body. Today, many people are interested in questions about under what factors anemia develops and what symptoms accompany the disease.
What is a disease?
In fact, B12-deficient anemia is known under various terms - percinious or megabloblastic anemia, malignant anemia, as well as Addison-Birmer disease. Such a disease is accompanied by a decrease in the number of red blood cells, which is associated with a deficiency of vitamin B12 (cyancobalamin). It is worth noting that not only bone marrow structures, but also nerve tissues are particularly sensitive to the lack of this substance, which, in fact, makes the disease extremely dangerous.
In most cases, patients are diagnosed with B12-folic deficiency anemia, in which there is also a lack of folic acid. The symptoms of the disease were first described relatively recently - in 1855, the English doctor T. Addison was engaged in the study of an unknown ailment. And already in 1926, researchers W. Murphy, J. Will, and J. Minot in their studies noted that the symptoms of the disease go away if a raw liver is introduced into the patient’s diet.
The main causes of B12 deficiency anemia
It is immediately worth noting 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 you need to mention the so-called nutritional deficiency, which develops as a result of insufficient intake of vitamin in the body with food. For example, a similar disease can develop against the background of starvation or strict veterinaryism. In an infant, this form of anemia is observed if the nursing mother refuses animal products.
- In some patients, there is a violation of the normal absorption of cyancobalamin.
- The causes of B12 deficiency anemia may be due to a lack of the so-called Castle internal factor. This specific complex substance, which is secreted by the intestinal mucosa, combines with cyanocobalamin and ensures its absorption. In turn, a deficiency of this substance can be caused by some congenital anomalies, as well as autoimmune diseases. In addition, the lack of Castle factor is observed with various structural changes in the stomach, for example, with gastritis, surgical operations, 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.
- The absorbing functions of the intestine can change in the presence of dysbiosis, in which the composition of the microflora changes.
- In some cases, cyancobalamin, which enters the body along with food, is absorbed by other "inhabitants" of the digestive system, such as pathogenic bacteria or worms.
- Risk factors include liver and kidney diseases, since against their background, an increase in the release of vitamin B12 or its incomplete use is often observed.
- Deficiency can also develop if tissues or organs absorb too much 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 active death of red blood cells.
Pathogenesis of the disease
How does B12 deficiency anemia develop? The pathogenesis of the disease is directly related to the basic functions of cyancobalamin. This vitamin plays an important role in the process of blood formation. Its deficiency leads to 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 is a cofactor in the most important metabolic reactions that are necessary for the functioning of nerve cells. That is why the nervous system suffers from its deficiency.
B12 deficiency anemia: symptoms of the disease
A similar disease is accompanied by a mass of symptoms, which are usually combined into three main groups.
To begin with, it's worth talking about 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 marked decrease in performance. As the disease progresses, tinnitus occurs periodically, as well as dizziness, and often fainting. Sick people also notice 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, stitching pains in the chest area.
Of course, with a deficiency of vitamin, digestive disorders 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 language, the surface of which is smoothed and acquires a bright red, and sometimes a raspberry shade, are also considered very characteristic.
Of course, this is not all the changes that accompany B12-deficient anemia. Symptoms also appear on the part of the nervous system. In the first place, peripheral nerve damage is observed. Patients note an unpleasant tingling sensation in the arms and legs, as well as temporary numbness of the limbs. Muscle weakness gradually develops. Due to the stiffness of the legs, a gradual change in gait is observed - it becomes more unstable.
Long-term deficiency of vitamin B12 leads to damage to the spinal cord, and then the brain. Symptoms of such disorders can be varied. For example, damage to the fibers in the spinal cord, as a rule, leads to a loss of sensitivity - a person no longer senses skin vibrations (most often the skin on the legs is affected). Some patients develop cramps. But increased irritability, uncontrolled changes in mood, impaired color perception indicate damage to the brain. In the absence of therapy, the patient may fall into a coma.
Forms of the disease
Of course, there are several classification schemes for the disease. It is important to know that in modern medicine, B12-deficient anemia can be of two types, depending on the cause of development:
- The primary form of the disease, as a rule, is associated with some genetic characteristics of the body. It is this B12-deficient anemia in infants that is most often observed.
- The secondary form of the disease develops already in the process of growing up and human life, under the influence of factors of the external or internal environment.
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 red blood cells (red blood cells) in the blood. Depending on this indicator, three stages of the disease are distinguished:
- With a mild form of anemia, the number of red blood cells ranges from 90 to 110 g / l.
- The moderate form of severity is characterized by a more significant decrease in the number of red blood cells - from 90 to 70 g / l.
- If the patient has a red blood cell count of 70 g / l or less, then we are talking about a severe form of B120-deficient anemia, which is extremely dangerous for health and even life.
Why is this form of anemia dangerous? Possible complications
Vitamin B12 deficiency anemia in the absence of timely treatment can be extremely dangerous. 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 chronic deficiency of cyanobalamin, the work of the whole body 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, hypoxia of the brain develops , which leads to a pernicious coma.
If you start treatment in the early stages, then all of the above complications can be avoided. Late-started 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-deficient anemia most often develops under the influence of various external factors, so the doctor will definitely be interested in information about the patient’s life, nutrition, 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 heart palpitations.
Naturally, further studies follow, with the help of which it can be determined whether B12-deficiency anemia actually takes place. A blood test for such a disease will demonstrate a decrease in the number of red blood cells and their progenitor cells (reticulocytes). Along with this, a decrease in the number of platelets is noted. Naturally, the hemoglobin level in the blood is also reduced. A biochemical blood test can also provide valuable information. With this type of anemia, an increase in blood levels of iron and bilirubin is observed.
Diagnosis of B12 deficiency anemia includes other procedures. In particular, bone marrow sampling is performed for laboratory tests (in most cases, sternum puncture is performed). In addition, the patient is tested for urine 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 to determine the cause of anemia.
B12 deficiency anemia: treatment
A doctor can draw up an effective treatment regimen only after a full examination of the body. So what therapy does B12 deficiency anemia require? Treatment begins with the elimination of the underlying cause of the disease. For example, with helminthic invasion, patients are prescribed antiparasitic drugs, and in the presence of a tumor, surgical intervention.
In addition, it is important to make up for the deficiency of cyancobalamin. In the first few days, the vitamin solution is administered intramuscularly. For an adult, the average daily dose is from 200 to 500 mcg. In especially severe conditions, the amount of medication 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 draw up the correct diet, including foods rich in cyanocobalamin and folic acid, which are primarily liver, meat and eggs.
Severe degrees of anemia require urgent replenishment of the number of red blood cells. To this end, red blood cells isolated from donated blood are administered to patients. The same procedure is necessary for anemic coma.
According to statistics, the prognosis for patients is quite good. The only exceptions are those cases when a person seeks help in a too serious condition, since it is impossible to restore the affected areas of the nervous system.
Are there effective prevention methods?
As you can see, B12-deficient anemia is an extremely 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 must respond to treatment on time - it is extremely important to follow the doctor’s recommendations and not abandon the prescribed medication. From time to time, it is recommended to take multivitamin complexes (once every six months) as a prophylaxis.
After an operation to remove parts of the intestine or stomach, the doctor must prescribe cyanobalamin preparations in the appropriate dose to the patient.