(Deficiency Of Vitamin B12) Megaloblastic anemia is caused by a vitamin B12 deficiency, which leads to an altered production of erythroblasts, their early destruction in the bone marrow (ineffective erythropoiesis) and a shortening of the half-life of the erythrocytes.
The daily minimum requirement of vit. B12 are ≤ 5 µg (average 2.4 µg). Its main sources are meat and milk. Body reserves are sufficient for 4 years. The vit. B12 is absorbed in the distal part of the small intestine after binding to the intrinsic factor (FI), which is produced in cells of the gastric mucosa. It binds to transcobalamin in the blood.
A vitamin B12 deficiency leads to changes in the synthesis of purine bases, which are necessary for DNA synthesis, which mainly affects tissues with high cell turnover (e.g. the lining of the digestive tract) and the CNS (changes in myelin metabolism and neuronal atrophy).
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Causes of Severe Deficiency Of Vitamin B12
1) Absorption disorders (caused by a defect in the Castle factor or the receptor for the absorption of the IF-B12 complex in the ileum): pernicious anemia (Biermer anemia), gastrectomy, bariatric surgery and ileum resection in the anamnesis, congenital deficiency of Castle -Factor, Helicobacter pylori gastritis, Crohn's disease, Zollinger-Ellison syndrome, bacterial overgrowth syndrome
2) congenital metabolic disorders, e.g. Ex. Transcobalamin deficiency
3) Nitric oxide, which is used in anesthesia.
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