B12-deficiency anemia: symptoms, causes, treatment

B12-deficiency anemia is a rather dangerous disease, which is associated with a violation of normal hematopoiesis that occur against a background of cobalamin deficiency in the body. Today, many people are interested in the question of what factors influence the development of anemia and what symptoms accompany the disease.

What is the disease?

In fact, B12-deficiency anemia is known under various terms - perceniosis or megabloblast anemia, malignant anemia, as well as Addison-Birmer disease. This 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, but also nervous tissues are particularly sensitive to the lack of this substance, which, in fact, makes the disease extremely dangerous.

In most cases, patients diagnosed with B12-folia deficiency anemia, in which there is a lack of folic acid. For the first time, the symptoms of the disease were described relatively recently - in 1855 the English physician T. Addison was studying an unknown disease. And already in 1926 the researchers U. Murphy, J. Will and J. Minot in their studies noted that the symptoms of the disease pass if you enter into the diet of the patient a raw liver.

The main causes of development of B12-deficiency anemia

Immediately it is 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 associated with changes in the body itself.

• To begin with, it is necessary to mention the so-called alimentary deficiency, which develops as a result of insufficient intake of vitamin in the body together with food. For example, a similar disease can develop against a background of fasting or strict veggie. In an infant this form of anemia is observed if the nursing mother refuses products of animal origin.
• In some patients there is a violation of the normal absorption of cyanocobalamin.
• The causes of B12-deficiency anemia may lie in the lack of the so-called internal factor of Castle. This specific complex substance, which is secreted by the intestinal mucosa, combines with cyanocobalamin and ensures its absorption. In turn, the deficit of this substance can be caused by some congenital anomalies, as well as autoimmune diseases. In addition, the lack of factor Castle 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 the intestinal tissues, which is observed in the presence of tumors or develops as a result of surgical excision of the part of the intestine.
• Suction functions of the intestine can change in the presence of dysbiosis, which changes the composition of the microflora.
• In some cases, cyanocobalamin, ingested with food, is absorbed by other "inhabitants" of the digestive system, for example pathogenic bacteria or worms.
• The risk factors include liver and kidney disease, 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 vitamin. A similar phenomenon is observed, for example, in the presence of a rapidly growing malignant tumor. Risk factors include hormonal changes and certain 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 cyanocobalamin. This vitamin plays an important role in the process of hematopoiesis. 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 exchange 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 divided into three main groups.

To begin with it is necessary to talk about the anemic syndrome, which develops against the background of a decrease in the number of red blood cells. Initially, patients complain of severe weakness, rapid fatigue and a marked decrease in performance. As the disease progresses, there is a periodic noise in the ears, as well as dizziness, and often fainting. Sick people also note the appearance of "flies" before the eyes. Signs of anemia can also include increased heart rate and severe dyspnoea, which occur even with the slightest physical exertion. Sometimes there are unpleasant, stitching pains in the chest area.

Of course, with a deficiency of the vitamin there are also disorders on the part of the digestive system. In particular, patients have a sharp decrease in appetite and, as a result, weight loss of the body. Occasional nausea and vomiting also bring a lot of inconvenience to a person's life. In addition, there are also possible disorders of the stool - most often these are long constipation. Very characteristic are the changes in the language, the surface of which is smoothed out and acquires a bright red, and sometimes crimson, hue.

Of course, this is far from all the changes that accompany B12-deficiency anemia. Symptoms also appear on the part of the nervous system. First of all, peripheral nerves are affected. Patients note unpleasant tingling in the hands and feet, as well as temporary numbness of the limbs. Gradually develops muscle weakness. In connection with the stiffness of the legs, a gradual change in gait is observed - it becomes more unstable.

Prolonged deficiency of vitamin B12 leads to damage to the spinal cord, and then to 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 feels the vibrations of the skin (most often the skin on the legs is affected). Some patients develop seizures. But increased irritability, uncontrolled mood changes, and color perception disorders indicate brain damage. In the absence of therapy, the patient may fall into a coma.

Forms of the disease

Of course, there are several schemes for classification of 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, as a rule, is associated with certain genetic characteristics of the body. It is this B12-deficiency anemia in infants most frequently observed.
• The secondary form of the disease develops already in the process of growing up and life of a person, 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 varies from 90 to 110 g / l.
• The average form of gravity 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, it is a severe form of B120-deficient anemia, which is extremely dangerous for health and even life.

What is the danger of this form of anemia? Possible complications

Anemia vitamin-B12-deficient in the absence of timely treatment can be extremely dangerous. As already mentioned, in the first place, the lack of this substance affects the state of the nervous system. The complications of this type of anemia include the defeat of the spinal cord and peripheral nerves. In turn, such violations are accompanied by discomfort and tingling in the limbs, complete and partial loss of sensitivity, incontinence of urine or feces.

Against the backdrop of chronic deficiency of cyanocobalamin, the work of the whole organism worsens, possibly the appearance of various diseases of the kidneys, heart and other organs. 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 the above complications can be avoided. Late begun therapy can eliminate vitamin deficiency, but, alas, changes in the nervous system are irreversible.

Modern diagnostic methods

In the presence of the above symptoms it is necessary to consult a doctor. After all, only a specialist can accurately determine the disease. For a start, a medical history is compiled. B12-deficiency anemia most often develops under the influence of certain external factors, so the doctor will necessarily inquire about information about the life of the patient, his nutrition, etc. Thereafter follows a physical examination. Patients with a similar disease, as a rule, can see the pallor of the skin. Often there is a decrease in blood pressure and heart palpitations.

Naturally, further studies are followed by which one can determine whether B12 deficiency anemia actually occurs. A blood test for a similar disease will show a decrease in the number of red blood cells and their progenitor cells (reticulocytes). Along with this, there is a decrease in the number of platelets. Naturally, the level of hemoglobin in the blood is lowered. A biochemical blood test can also provide valuable information. With this type of anemia, there is an increase in blood levels of iron and bilirubin.

Diagnosis of B12-deficiency anemia involves other procedures. In particular, for bone marrow sampling (in most cases, the sternum is punctured). In addition, the patient gives analysis of urine and feces. Electrocardiography, electroencephalography, computed tomography, and sometimes some other procedures are shown - these tests are necessary in order to assess the extent of damage to other organ systems, and to determine the cause of anemia.

B12-deficiency anemia: treatment

A doctor can make 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 helminthic invasion, patients are prescribed antiparasitic drugs, and in the presence of a tumor - surgical intervention.

In addition, it is important to fill the deficiency of cyanocobalamin. In the first few days, the vitamin solution is injected intramuscularly. For an adult, the average daily dose is 200 to 500 μg. In particularly severe conditions, the amount of the drug is increased to 1000 μg - this scheme is adhered to for three days. After achieving stable improvements, the dose is reduced to 100-200 μg - 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, in the first place liver, meat and eggs.

Severe anemia requires urgent replenishment of the number of red blood cells. To this end, patients are injected with red blood cells isolated from donor blood. The same procedure is necessary for anemic coma.

According to statistical data, the prognosis for patients is quite favorable. Exceptions are only those cases when a person turns for help in too serious a state, since it is impossible to restore the affected parts of the nervous system.

Are there effective methods of prevention?

As you can see, B12-deficiency anemia is a very dangerous disease. That's why it's much easier to try to avoid it. And in this case, properly composed diet is very important. Make sure that your menu is regularly attended by foods that are rich in cyanocobalamin. In particular, vitamin B12 is found in eggs, meat, liver and dairy products.

All diseases of the gastrointestinal tract must be treated in time - it is extremely important to follow the doctor's recommendations and not to abandon the medications prescribed by him. From time to time it is recommended as a preventive measure to take multivitamin complexes (once every six months).

After surgery to remove parts of the intestine or stomach, the doctor must prescribe the patient preparations of cyanocobalamin in the appropriate dose.