Three check items for anemia diagnosis, part 3: Vitamin B12
(1) Vitamin B12
Vitamin B12 is an important nutrient for the human body. It participates in the production of bone marrow red blood cells, prevents pernicious anemia, and prevents damage to brain nerves. Vitamin B12 deficiency can lead to hematopoietic and nervous system abnormalities.
Clinical significance:
Reduce:
1. Megaloblastic anemia: Megaloblastic anemia occurs due to intestinal malabsorption due to the lack of intrinsic factor, which causes nucleic acid synthesis disorders and affects the division of red blood cells.
2. Chronic pancreatitis: Trypsin deficiency results in loss of R protein degradation, which competes with intrinsic factors and inhibits the absorption of VB12.
3. Zollinger-Ellison Syndrome: The decrease in pH in the small intestine affects the absorption of VB12.
4. Drug effects: For example, sodium aminosalicylate, neomycin, etc. can affect the absorption of VB12, resulting in a decrease in blood content.
5. Others: neural tube defects, recurrent oral ulcers, stomatitis, alcoholism, pregnancy, chronic renal insufficiency, gastric cancer, acute lymphoblastic leukemia, diabetes, etc.
Increase:
1. Leukemia: VB12 in blood may increase nearly 10 times higher than normal, which may be related to the massive destruction of leukemia cells and the release of VB12.
2. Polycythemia vera: Serum VB12 is elevated.
3. Lymphoma and proliferative anemia.
4. Liver diseases: cirrhosis, biliary cirrhosis, portal cirrhosis, etc.
5. Malignant tumors.
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