Anaemia pernicious

Vitamin B,2 is produced by the growth of certain micro-organisms, and occurs also in liver, being the extrinsic anti-pernicious anaemia factor the isolation of which was sought for many years. 

The vitamin deficiency is often due to failure to absorb B12 from the stomach and can be alleviated by giving mg doses with extracts of hog s stomach which contains the intrinsic anti-pernicious anaemia factor (a muco-protein), which promotes the absorption. 

Pernicious anaemia was a fatal disease first reported in 1880. It was not until 1926 that it was discovered that eating raw liver effected a remission. The active principle was later isolated and called vitamin B or cyanocobalamin. It was initially obtained... 

Cyanocobalamin (vitamin B12) Propionibacterium freudenreichii Propionibacterium shermanii Pseudomonas denitriTicans Treatment of pernicious anaemia... 

Pernicious anaemia, due to B12 deficiency, is one example of the class of anaemias known as megaloblastic anaemias, resulting from an abnormality in erythroblast maturation. 

Stockbruegger RW, Cotton PB, Menon GG, Beilby JOW, Bartholomew BA, Hill MJ, et al Pernicious anaemia, intragastric bacterial overgrowth, and possible consequences. Scand J Gastroenterol 1984 19 355—364. 

G9. Grasbeck, R., Kantero, I., and Srurala, M., Influence of calcium ions on vitamin B12 absorption in steatorrhea and pernicious anaemia. Lancet i, 234 (1959). 

G8. Girdwood, R. H., The occurrence of growth factors for Lactobacillus leich-mannii, Streptococcus faecalis and Leuconostoc citrovorum in the tissues of pernicious anaemia patients and controls. Biochem. J. 52, 58-63 (1952). 

Decreased AP-levels could be seen in patients suffering from hypoparathyroidism and pernicious anaemia (i.e., an anaemia tending to be a fatal issue). 

Most importantly, the determination of cortisol levels is considered useful in the diagnosis and treatment of various ailments, namely Addison s Disease i.e., pernicious anaemia—a condition whereby the maturation of the red cells may not proceed beyond the stage of megaloblasts Cushing s Syndrome. 

Very small amounts of cobalamin are required each day (<5 i.g) and the diet normally provides plenty more than the minimum, so dietary B12 deficiency is uncommon, except in very strict vegetarians. Pernicious anaemia arises when a defect in the stomach results in too little secretion of a protein called intrinsic factor, without which, cobalamin cannot be absorbed in the ileum of the small intestine. 

Vitamin Bn deficiency Deficiency, although rare, results in two serious problems megaloblastic anaemia (which is identical to that caused by folate deficiency) and a specific neuropathy called Bi2-associated neuropathy or cobalamin-deficiency-associated neuropathy (previously called, subacute combined degeneration of the cord). A normal healthy adult can survive more than a decade without dietary vitamin B12 without any signs of deficiency since it is synthesised by microorganisms in the colon and then absorbed. However, pernicious anaemia develops fairly rapidly in patients who have a defective vitamin B12 absorption system due to a lack of intrinsic factor. It results in death in 3 days. Minot and Murphy discovered that giving patients liver, which contains the intrinsic factor, and which is lightly cooked to avoid denaturation, cured the anaemia. For this discovery they were awarded the Nobel Prize in Medicine in 1934. 

Macrocytic and hyperchromic cells Folate deficiency Pernicious anaemia Myelodysplasia... 

In the adult population, the prevalence of overt hypothyroidism is 19 per 1000 women and 1 per 1000 men with annual incidence of overt hypothyroidism is 4 per 1000 women and 0.6 per 1000 men. Subclinical hypothyroidism is also more common in women, the incidence increases with age, with up to 10% of women older than 60 years having an increased thyroid-stimulating hormone concentration. Subclinical hypothyroidism is more common in people who have been treated for hyperthyroidism with radioactive iodine or surgery, and in those with organ-specific autoimmune diseases, such as pernicious anaemia, type 1 diabetes mellitus, or Addison s disease. 

Vitamin B12 Vitamin B12 is an important cobalt complex. The vitamin was isolated from liver after it was found that eating large quantities of raw liver was an effective treatment for pernicious anaemia. The term vitamin B12, refers to cyanocobalamin. Vitamin B12 is a coenzyme, and serves as a... 

Megaloblastic anaemia (pernicious anaemia), demyelinating neurological lesions in the spinal cord infertility. 

Vitamin B12 deficiency normally results from indequate absorption rather than inadequate dietary intake. Pernicious anaemia is caused by vitamin B12 deficiency symptoms include anaemia, glossitis, fatigue and degeneration of the peripheral nervous system and hypersensitivity of the skin. The adult RDA and RNI for B12 are 2 and 1.5 figday- respectively. Unlike other vitamins, B12 is obtained exclusively from animal food sources, such as meat, fish, poultry, eggs, shellfish, milk, cheese and eggs. Vitamin B12 in these foods is protein-bound and released by the action of HC1 and pepsin in the stomach. 

Vitamin B]2 is a red crystalline, cobalt-containing compound that can be isolated from the liver. It has a functional role in preventing pernicious anaemia and also serves as a coenzyme in hydrogen and methyl transfer reactions (Co appears to be the only metal in vivo catalyzing C transfer reactions O and N transfers are more common). Vitamin B12 is also a growth-promoting factor for several microorganisms. 

Co 71 d P+ e+ 0.49 5SNi(n,p)5aCo — Pernicious anaemia diagnosis... 

The B12 class compounds are required in only very small amounts, consistent with the poor bioavailability of cobalt, and are used mainly by microorganisms, which can also synthesise them. In mammals, the B12-dependent methylmalonyl-CoA mutase system is of particular importance, however. It is required for amino acid metabolism in the liver and its absence, as a result of genetic defects, is lethal. Indeed, as early as the 1920s it was observed that extracts from animal livers could cure otherwise lethal pernicious anaemia. The presence of cobalt was detected in these liver extracts and this led to... 

W7. Weaver, J. A., and Neill, D. W., Aminoaciduria in pernicious anaemia and subacute combined degeneration of cord. Lancet i, 1212-1213 (1954). 

BI4. von Bonsdorff, B., The site of infestation with fish tapeworm determined by means of intestinal intubation. Diphyllobothrium and pernicious anaemia. Acta Med. Scand. 129, 213-23 (1947). 

Cl. Castle, W. B., Observations on the etiologic relationship of achylia gastrica to pernicious anaemia. I. The effect of the administration to patients with pernicious anaemia of the contents of normal human stomach recovered after the ingestion of beef muscle. Am. J. Med. Sci. 178, 748-764 (1929). 

C9. Cooper, B. A., and Whitehead, V. M., Evidence that some patients with pernicious anaemia are not recognized by radiodilution assay for cobalamin in serum. N. Engl. J. Med. 299, 816-818 (1978). 

C18. Crosby, W. H., Improvisation revisited. Oral cyanocobalamin without intrinsic factor for pernicious anaemia. Arch. Intern. Med. 140, 1582 (1980). 

H17. Hall, M., and Davidson, R. J. L., Prophylactic folic acid in women with pernicious anaemia pregnant after periods of infertility. J. Clin. Pathol. 21, 599-602 (1968). 

H18. Heaton, D., Another case of megaloblastic anaemia of infancy due to maternal pernicious anaemia. N. Engl. J. Med. 300, 202-203 (1979). 

L13. Lillibridge, C. B., Brandborg, L. L., and Rubin, C. E., Childhood pernicious anaemia. Gastrointestinal secretory, histological, and electron microscopic aspects. Gastroenterology 52, 792-809 (1967). 

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