TAILIEUCHUNG - Chapter 100. Megaloblastic Anemias (Part 8)

Table 100-4 Malabsorption of Cobalamin May Occur in the Following Conditions But Is Not Usually Sufficiently Severe and Prolonged to Cause Megaloblastic Anemia Gastric causes Simple atrophic gastritis (food cobalamin malabsorption) Zollinger–Ellison syndrome Gastric bypass surgery Use of proton pump inhibitors Intestinal causes Gluten-induced enteropathy Severe pancreatitis HIV infection Radiotherapy Graft-versus-host disease Deficiencies of cobalamin, folate, protein, ?riboflavin, ?nicotinic acid Therapy with colchicine, para-aminosalicylate, neomycin, slow-release potassium chloride, anticonvulsant drugs, metformin, phenformin, cytotoxic drugs Alcohol Pernicious Anemia Pernicious anemia (PA) may be defined as a severe lack of IF due to gastric atrophy. . | Chapter 100. Megaloblastic Anemias Part 8 Table 100-4 Malabsorption of Cobalamin May Occur in the Following Conditions But Is Not Usually Sufficiently Severe and Prolonged to Cause Megaloblastic Anemia Gastric causes Simple atrophic gastritis food cobalamin malabsorption Zollinger-Ellison syndrome Gastric bypass surgery Use of proton pump inhibitors Intestinal causes Gluten-induced enteropathy Severe pancreatitis HIV infection Radiotherapy Graft-versus-host disease Deficiencies of cobalamin folate protein riboflavin nicotinic acid Therapy with colchicine para-aminosalicylate neomycin slow-release potassium chloride anticonvulsant drugs metformin phenformin cytotoxic drugs Alcohol Pernicious Anemia Pernicious anemia PA may be defined as a severe lack of IF due to gastric atrophy. It is a common disease in north Europeans but occurs in all countries and ethnic groups. The overall incidence is about 120 per 100 000 population in the United Kingdom UK . The ratio of incidence in men and women in Caucasians is 1 and the peak age of onset is 60 years with only 10 of patients being 40 years of age. However in some ethnic groups notably black individuals and Latin Americans the age of onset of PA is generally lower. The disease occurs more commonly than by chance in close relatives and in persons with other organspecific autoimmune diseases . thyroid diseases vitiligo hypoparathyroidism and Addison s disease. It is also associated with hypogammaglobulinemia .

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