PERNICIOUS ANAMIE

. Perniciousanemia is an autoimmune disorder in which the body fails to make enough healthyred blood cells. The body requires vitamin B-12 and a type of protein calledintrinsic factor (IF) to make red blood cells. Vitamin B-12, or cobalamin, isfound in certain foods and medications. IF is a protein made by  the stomach mucus-secreting cells,called parietal cells. When vitamin B-12 enters the body, it binds with IF. Thetwo are then absorbed in the last part of the small intestine. In the majorityof cases of PA, the body’s immune system attacks and destroys the stomach’smucosal cells. IF can no longer be made, and vitamin B-12 cannot be absorbed Ina healthy immune system, antibodies are responsible for finding bacteria orviruses. They then mark the invading germs for destruction. In an autoimmunedisease, such as PA, the body’s antibodies stop distinguishing between diseaseand healthy tissue. In this case, they demolish the cells making IF. VitaminB-12 deficiency produces a small number of overly large and ineffective RBCscalled macrocytic. Because of their large size, these cells may not be able toleave the bone marrow and enter the bloodstream. The resulting decrease inoxygen-carrying RBCs in the bloodstream can lead to fatigue and weakness. Accordingto the National Heart, Lung, and Blood Institute (NHLBI), this type of anemiais called “pernicious” because it was once considered a deadly disease. Thiswas due to the lack of available treatment. Today, the disease is relativelyeasy to treat with B-12 shots or supplements. (NHLBI, 2001) However,untreated vitamin B-12 deficiency can lead to more severe complications such asneurological problems, chronic anemia, and stomach cancer RISK FACTOR   Pernicious  anemiais more common in people of northern European and African descent than in otherethnic groups .list of this disease risk factors are listed below but the listis not exhaustive; v Age v Family history v Lack of stomach acids and intrinsic factor v Autoimmune disorder e.g. graves syndrome v Have had stomach or intestine surgically removed v Have certain intestinal disorder v Medication v  If you are a strictvegetarian v Lack of intrinsic factor v Malabsorption in the small intestine        Symptoms   PA develops very slow, making it difficult forpatients to recognize symptoms because they have grown accustomed to feeling“unwell.” Commonly overlooked symptoms include:v  headachesv  chest painv  weight lossv  low red blood cellsv  coldness in your hands and feetv  heartburnv  dizzinessv  enlarged smooth, red tonguev  loss of appetitev  constipation or diarrheav  pale or yellowish skinInrare cases of PA, patients may display neurological symptoms including: v  unsteady   gait/loss of balancev  spasticity (stiffness and tightness in themuscles)v  peripheral neuropathy (damage to thenerves in your arms and legs)v  progressive lesions of the spinalcord v  memory lossv  depressionv  confusion   Diagnosis Adiagnosis of PA requires several different tests. It requires a:v  complete blood count (CBC) testv  vitamin B-12 deficiency testv  IF deficiency testCBCmeasures the amount of:v  hemoglobin - protein bound to oxygento carry it throughout the bloodv  hematocrit - used to measure howmuch space red blood cells use within the bloodv   Vitamin B-12 levels are assessed through ablood test. Low levels indicate a deficiency.v  Damage to the stomach walls iseasily diagnosed through a biopsy. A biopsy removes a sample of the stomach’scells. The cells are examined microscopically for damage.v   Intrinsic factor deficiency is tested througha blood sample. The blood is tested for antibodies against IF and the stomach’smucosal cells. Treatment   Thetreatment for PA is a two-part process:v  first, treat any existing vitaminB-12 deficiency and check for iron-deficiencyv  second, lifelong surveillance forlong-term consequencesTreatment begins with:v  vitamin B-12 injections that areslowly decreased over timev  blood test for iron deficiencyfollowed by regular blood testsv  CBC tests to measure serum cobalaminand ferritin levelsv  blood tests to monitor replacementtreatmentsØ  Symptoms of long-term damageinclude: v  upset stomach v  difficulty swallowingv  weight lossv  iron deficiencyØ  Lifelong surveillance focuses onidentifying serious consequences. The most dangerous is gastric cancer. Studieshave shown a link between damage done to the stomach’s lining by PA and gastriccancer. Regular visits and biopsies are able to check for thebeginnings of cancer.  Tips andsteps on prevention  These few steps can prevent you from pernicious anemia ü  Avoid over consuming alcohol ü  Have your doctor check you for iron deficiency ü  Undergo test if your doctor suspect you are infected with bacteria helicobateria pylori. ü  Eating food with high vitamin B12 such as; v Breakfast cereals with added vitamin B12 v Meat; such as beef, liver, poultry and fish v Egg and dairy products such as milk yoghurt and cheese v Foods fortified with vitamin B12 such as soy based beverages andvegetarian burgers.     -  Microbiologist maya salmat salisu  Facebook I’d; maya salis/mayasalisu Salmat_salisu@yahoo.com salmatmaya@gmail.com 08037498259,08155509092.

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