Vitamin B12 (cyanocobalamine) Deficiency

-The most common cause of B12 deficiency is pernicious anemia

-Causes :

.inadequate dietary intake of vitamin B12

.atrophic gastritis (in which case, the resulting megaloblastic anemia takes the name of "pernicious anemia"), or may result from wide surgical resection of stomach

.resection of the terminal ileum (the principal site of vitamin B12 absorption)

.surgical removal of the small bowel

.long-term use of ranitidine hydrochloride

.Celiac disease

-Symptoms & Signs :

.lemon tinge

.jaundice

.angular cheilosis (stomatitis)

.irritability,depression,dementia

.peripheral neuropathy

.sexual dysfunction

.diarrhea and abdominal pain

+Features of pernicious anemia :

.Usually over 30 years, with blue eyes (elderly)

.Subacute combined degeneration of the cord can occur

.Optic atrophy can occur

.Weight loss is a common feature

.Subacute combined degeneration can occur

.Gastric atrophy with achlorhydria

+Significant in blood film is (hypersegmented neurophils)

+The mejor deference between Vit12 and folate deficiency is (neuropathy-foot paresthesia)

Folic Acid Deficiency

-Is a low level of folic acid in the body. Also known as vitamin B9, it is involved in adenosine,is absorbed throughout the small intestine

-Cuases :

.crohn's disease

.coeliac disease

.tetrahydrofolic acid

-Symptoms & Signs :

.loss of appetite and weight loss

.weakness

.sore tongue

.headaches

.heart palpitations

.irritability, and behavioral disorders

.women with folate deficiency who become pregnant are more likely to give birth to low birth weight premature infants, and infants with neural tube defects. neural tube defects

+About megaloblastic anemia :

.Megaloblastic anemia secondary to folate deficiency

.Serum folic acid and vitamin B12 are not normal

.Manifestation may appear in the first year of life

.White blood cells and platelets are normal

.Occasionally treatment is required for life

.In Jordan goat's milk may be a factor in its etiology

Hymolytic Anemia

-Is a form of anemia due to hemolysis, the abnormal breakdown of red blood cells (RBCs), either in the blood vessels (intravascular hemolysis) or elsewhere in the human body (extravascular)

-Causes :

.hereditary spherocytosis and hereditary elliptocytosis

.thalassemia, sickle-cell disease and congenital dyserythropoietic anemia

.glucose-6-phosphate dehydrogenase deficiency and pyruvate kinase deficiency

-Symptoms & Signs :

.fatigue

.shortness of breath

.jaundice

.gallstones

.pulmonary hypertension

+Hemolysis may occur in (hemolytic anemias) :

.Hereditary spherocytosis

.Thalassemia

.Sickle cell anemia

.Glucose-6-phosphate deficiency

.Hereditary elliptocytosis

Sickle Cell Anemia

-It is autosomal recessive diorder causing production of abnormal beta globin chains

-More common in black / Increased incidence of salmonella osteomyelitis / Sickle cell tract are usually asymptomatic

-Features may be found in an adult with sickle cell anemia :

.Aseptic necrosis of bone

.Chronic leg ulcers (skin ulcers)

.Hematuria

.Impaired ability to concentrate urine

.Predisposes to autosplenectomy (splenic autoinfarction)

.Stroke

.Vaso-occlusive crisis

.Infection

.Organ damage

.Chest Syndrome (acute chest syndrome)

.aplastic crisis

.UTI,papillary necrosis

.Newborn usually without symptoms

G6PD Deficiency

-Also known as favism (after the fava bean) is an X-linked recessive genetic condition that predisposes to hemolysis (spontaneous destruction of red blood cells) and resultant jaundice in response to a number of triggers, such as certain foods, illness, or medication

-G6PD deficiency is the most common human enzyme defect

-Tme most common type of oxidant stress is actually from infections,not drugs

(Infection,Sulfa drugs,Fava beans,Nitrofurantoin)

-Favism is a hemolytic anemia caused by deficiency of (Glucose-6-phosphate dehydrogenase)

-The most common implicated drugs are (sulfa drugs,primiquine,dapsone,quinidine,nitrofurantion)

-The usual findings of an intravascular hemolysis include high LDH,bilirubin,reticulocyte count with a normal MCV

-Symtoms :

.jaundice

.dark urine

.weakness

.tachycardia

Date: 2016-04-22; view: 540