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The intestine, the organ of absorption of blood-forming factors (vitamin B12, folic acid and iron), plays an independent role in blood formation. We are referring to the synthesis of a number of “growth factors”, vitamins by intestinal microorganisms, of which the most important in the physiology of the blood system are folic acid and vitamin B12.
Impaired intestinal absorption in relation to vitamin B12, folic acid, gland, and impaired biosynthesis of folic acid lead to the development of anemia. The best known are pernicious-anemic conditions that occur with prolonged enteritis, pellagra, and especially with sprue (the so-called pernicious sprue anemia). Pernicious-like (or spruob-like) anemias often arise in connection with organic lesions of the intestines (poses, malignant tumors and hyperplastic-blastomic processes - reticulosarcomatosis, lymphogranulomatosis), with diverticula, strictures and large resections of fine lymphoma; as well as in connection with the operation of ileoectomy. The pathogenesis of B12 -deficiency anemia in the latter cases is associated with loss of function of the intestinal acceptor protein.
Pathogenesis. Causes of macrocytic and megalocytic, resp. pernicious, anemia that occurs with various anatomical and functional lesions of the small intestine, are more complex than agastral anemia. There is no doubt that the origin of these forms of anemia, which we combine under the common name of anenteral anemia, plays a role in the absorption of both iron and anti-anemic factors in the affected intestine - vitamin B12, folic acid. Dysbacteriosis also matters, as a result of which, on the one hand, folic acid biosynthesis processes are disrupted by lactic acid bacteria, and on the other hand, the flora (E. coli) multiplying in the small intestine competes with the macroorganism regarding the use of dietary vitamin.
It should be noted that, in contrast to the pure form of B12 monoavitaminosis, which develops with the loss of gastric (more precisely, fundic) secretion and realizes a picture of typical pernicious anemia, lesions of the small intestine, accompanied by general (protein, mineral and multivitamin) deficiency, lead to the development of mixed, B12 (folic) -zhelezdepletsnoy anemia.
The real possibility of the development of macrocytic anemia, resp.
pernitsiozopodobny type depending on the impaired resorption function of the small intestine is confirmed by observations of persons who underwent partial bowel resection for various reasons.
So, Wintrobe describes the development of sprue-type diarrhea and macrocytic anemia in a patient who, 5 years before, 317 cm of small intestines had been removed.
We (1954) observed a 33-year-old patient who, 10 years after resection of the small intestine (275 cm), made in connection with a gunshot wound to the abdominal cavity (in 1944), developed a typical pernicio-anemic coma (hemoglobin 18 units, erythrocytes 840,000 ), from which it was removed by transfusions of the erythrocyte mass and the introduction of vitamin B12.
Less typical are anenteral iron deficiency anemia, occurring in the form of chlorosis, with a low color index, low content of iron, plasma, but with macrocytosis of erythrocytes.
Treatment. Therapy of anenteral anemia is carried out according to the general rules of iron-vitamin (B12-folic) deficiency anemia treatment. Given the violation of intestinal absorption, all antianemic drugs should be prescribed parenterally. Repeated whole blood transfusions are shown. Due to a violation of the general, mainly protein, nutrition, patients are shown a diet rich in proteins and vitamins.
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- ANEMIA DUE TO TOXIC EXPOSURE OF THE BONE MARROW (MYETHOXICAL ANEMIA)
THYROORTHEUS ANEMIA Thyroid stimulation anemia is anemia that develops on the basis of hypothyroidism. Experimental work confirms the important role of thyroid hormone - thyroxin - in stimulating normal blood formation. Animals deprived of the thyroid gland, quickly anemiziruyutsya, the introduction of the same thyroid drugs to thyroidectomized animals cures them from the effects of thyroid-induced
- ANEMIA UNDER CONDITIONS OF FUNCTIONAL AGASTRY (AGASTRAL ANEMIA)
In contrast to the actual agastric anemia associated with partial or complete anatomical removal of the stomach, we distinguish anemia that develops in conditions of functional agastria, when the anatomically preserved stomach partially or completely turns off from the physiological process of digestion and, in particular, loses the ability to assimilate the external antianemic factor - Vitamin B12.
- Anemia associated with impaired synthesis of DNA and RNA (megaloblastic anemia)
Megaloblastic anemia unites a group of acquired and hereditary anemias, a common feature of which is the presence of megaloblasts in the bone marrow. Regardless of the etiology of the patients, hyperchromic anemia with characteristic changes in the erythrocyte morphology is revealed - oval red blood cells, large (up to 12-14 microns or more). There are red blood cells with basophilic cytoplasm, in many of
- Anemia associated with impaired synthesis or utilization of porphyrins (sideroachrestic, sideroblastic anemia)
This is a heterogeneous group of diseases, hereditary and acquired, associated with a violation of the activity of enzymes involved in the synthesis of porphyrins and heme. The term "sideroahresticheskaya anemia" was introduced by Iewer (1957). In case of sideroachrestric anemia, serum iron levels are elevated. In the bone marrow detect ring-shaped sideroblasts - nucleated red blood cells with a nucleolus corolla,
- Anemia due to bone marrow drainage, hypothyroidism, and aplastic anemia. MYELOPLASTIC SYNDROME
Despite the large number of studies devoted to the study of hypo-and aplastic anemias, it is still not possible to create a rational classification of these conditions, since not only the issues of pathomorphogenesis, but even the definition of the very concept of "hypo (a) plastic anemia" is debatable. In accordance with modern concepts of the genesis of hypo-
- Anemia due to blood loss, post-hemorrhagic anemia
Anemia due to blood loss, post-haemorrhagic
- ACQUIRED HEMOLYTIC ANEMIA
Acquired hemolytic anemias include: • immune hemolytic anemia; • drug hemolytic anemia; • traumatic and microangiopathic hemolytic anemia; • anemia caused by hemolytic poisons, chemicals, bacterial toxins; • paroxysmal night
- Lecture. Anemia Hemorrhagic syndrome, 2010
Post-hemorrhagic anemia. Iron deficiency anemia. Aplastic (hypoplastic) anemia. Hemolytic
Anemia - a condition characterized by a decrease in hemoglobin per unit volume of blood by reducing its total amount in the body. In most cases, anemia is also accompanied by a decrease in the number of red blood cells per unit volume of blood. From true anemia should be distinguished hydremia - blood thinning due to tissue fluid. At the heart of the development of anemia are various pathological processes in
- Dizerythropoietic anemia (due to impaired erythropoiesis)
This group of diseases includes: a) anemia, combined by a common mechanism of occurrence associated with impairment or termination of erythropoiesis as a result of a deficiency of substances necessary for normal blood formation - deficient anemia (B12 -, B6 -, B2 - folic acid, iron-copper cobalt-deficient, protein-deficient), as well as anemia, arising from the inability of the bone marrow
- Acquired hemolytic anemia
This is a heterogeneous group of hemolytic anemias that occur under the influence of a number of factors that have the ability to damage red blood cells and cause their premature destruction. Classification of acquired hemolytic anemia [Idelson LI, 1975] I. Hemolytic anemia associated with exposure to antibodies. 1. Isoimmune hemolytic anemia 1) hemolytic disease of the newborn
- Deficient anemia
-Anamnesis: eating disorders, digestive disorders -sm anemia: pallor of the skin and mucous membranes, reducing the amount of hemoglobin and red blood cells -hyperplastic sm: an increase in the liver and spleen according to the severity of the disease -hemolytic cm: jaundice, splenomegaly, increase in indirect bilirubin in the blood - hemorrhagic sm is expressed only in severe forms - laboratory
Anemia (anemia) is a condition characterized by a decrease in hemoglobin concentration in a unit blood volume below normal. Often, but not always, this decrease occurs while simultaneously reducing the total mass of red blood cells per unit volume of blood. Anemia develops when the rate of their reproduction in the bone marrow decreases due to the destruction or loss of red blood cells. Therefore, there are two large
- Hemolytic anemia
Hemolytic anemias make up an extensive group of anemic states of various etiologies, a common feature of which is the pathologically increased destruction of red blood cells. It is known that the average lifespan of erythrocytes does not exceed 100-120 days. Hemolytic anemia is characterized by shortening the life span of red blood cells. Hemolysis can occur intracellularly or
- Dehydropoietic anemia
Despite the fact that the number of cells in the bone marrow in these diseases is normal or increased, the production of red blood cells is reduced. This decrease is associated with impaired or insufficient erythropoiesis, therefore, anemia develops. The causes of dairytopoietic anemia are as follows. • Primary Hereditary Acquired (myelodysplastic syndromes) • Secondary Reduced DNA synthesis Megaloblastic