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B12 Deficiency Anaemia Flashcards

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2712790641AetiologyAbsence of intrinsic factor which leads to B12 deficiency0
2712790993TypeSystemic disease, chronic1
2712791129Risk FactorsInfections of surgery that inhibit absorption of B12. Vegetarian/Vegan diet. Bad Bacteria. Diseases such as celiac, crohn's etc. Surgical removal of part/all small intestine. Autoimmune disease.2
2712802156PathogenesisInsufficient intrinsic factor, decreased absorption of Vitamin B12, ,affects normal RBC development, creating macrocytic (large cells, RBCs), these defective cells die early, insufficient numbers of erythrocytes, causing hypoxaemia - tissue hypoxia. Pernicious anemia is a normochromic form of anaemia meaning the concentration of haemoglobin in RBCs in normal but there are insufficient numbers of RBCs.3
2712803762Clinical ManifestationsEarly symptoms are nonspecific and vague: infections, mood swings, and gastrointestinal, cardiac or kidney ailments. When haemoglobin has decreased to 70-80g/L: weakness, fatigue, paresthesias of feet and fingers, difficulty walking, loss of appetite, abdominal pain, weight loss, sore, smooth, beefy red tongue. Skin may become lemon yellow (combo of pale and jaundice). Neurological abnormalities such as numbness, weakness, and unsteady gait.4
2712805559Red FlagsAbdominal Pain, Weight Loss5
2712806223Diagnostic ApproachesEvaluation is based on blood tests, bone marrow aspiration (draw out), serological studies, gastric biopsy, clinical manifestations and the Schilling Test. Serological studies reveal presence of antibodies against gastric cells and gastric biopsy reveals achlorhydria.6
2712807316Associated ComplicationsUntreated pernicious anaemia is fatal, usually because of heart failure. Also can cause progressive damage to the nervous system (esp nerves outside brain and spinal cord). Other complications are same as iron def. anaemia.7
2712808283PrognosisWith replacement therapy of Vitamin B12, mortality has decreased significantly.8
2712808489Medical TreatmentInitial replacement therapy of Vitamin B12 is by weekly injections until deficiency is corrected. Monthly injections for the remainder of their life, recent practice is showing oral administration of high dose Vitamin B12 beneficial.9
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