Definition
Pernicious anemia outlines a particular form of anemia associated essentially with the deficiency of vitamin B12 (Cobalamin), caused in turn by a malabsorption of the same. Since vitamin B12 is essential for the growth of red blood cells, its deficiency causes a decrease in red blood cells.
Causes
Autoimmune disease → atrophy of the gastric glandular mucosa → absence of intestinal intrinsic factor (useful for absorbing vitamin B12) → malabsorption of vitamin B12 → pernicious anemia
The possible causes of pernicious anemia are: abuse of anti-ulcer drugs, surgical removal of the ileum or part of the stomach (sites of absorption of vitamin B12), celiac disease, vegetarian diet, H. Pylori infection, insertion of a bypass gastric, Crohn's disease.
Symptoms
Clinical evidence shows that pernicious anemia patients have very high amounts of gastrin; in addition, the disease begins with alteration of taste perception, increased serum bilirubin levels, jaundice skin, concentration difficulties, atrophic glossitis (red and smooth lingual mucosa), irritability, headache, memory lapses. In severe cases, pernicious anemia involves the nervous system.
Information on Pernicious Anemia - Drugs for the Treatment of Pernicious Anemia is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Anemia Perniciosa - Drugs for the Treatment of Pernicious Anemia.
drugs
If until recently pernicious anemia was included among incurable and potentially lethal diseases, it is currently considered a treatable and fortunately not very widespread disease.
The therapy of choice is represented by the administration (generally, by intramuscular injection) of vitamin B12 which, as we have seen, is deficient in the pernicious anemia patient.
Eventually, supplementation with iron supplements can be completed.
Supplementation of vitamin B12 : indispensable for guaranteeing the survival and cancellation of symptoms in patients suffering from pernicious anemia:
- Cyanocobalamin (eg Tonocian, Disepavit, Epargriseovit): it is the drug of first choice for the treatment of pernicious anemia. By parenteral route, start the administration of the drug at a dose of 100 mcg, intramuscularly, to be taken once a day for a week; in the case of a positive response, continue taking the drug every 2 days (for 7 days); then administer the active ingredient every 3-4 days for another 2-3 weeks. In general, most pernicious anemia patients require monthly administration of the drug at a dose of 100-1, 000 mg intramuscularly throughout their lives. Alternatively, cyanocobalamin can be taken in the form of a nasal spray or nasal gel (500 mcg in one nostril, once a week), only when pernicious anemia does not involve the nervous system.
- Cobamide (eg. Cobaforte): indicated for the treatment of pathologies characterized by a lack of vitamin B12, including pernicious anemia. The drug is an enzymatic form of vitamin B12 which, protected by the intrinsic factor, is subsequently absorbed into the duodenum. Available as 2.5 mg capsules, it is recommended to take 2 capsules a day. The drug can also be administered intramuscularly when the vitamin B12 deficiency is particularly severe.
Iron supplementation: sometimes, the patient suffering from pernicious anemia may also need iron salts supplementation:
- Ferrous sulphate (eg Ferrograd): antianemic par excellence, ferrous sulfate is widely used in martial therapy (iron deficiency anemia). Generally, the drug is available in the form of 595 mg active release controlled tablets. It is recommended to take 1 tablet a day, with water. The drug requires a medical prescription. To improve absorption, it is recommended to take the drug with vitamin C (eg with a glass of orange juice).
- Iron fumarate (eg Organic Iron): start therapy for iron deficiency anemia with 325 mg of oral drug once a day. Continue with maintenance therapy by taking 325 mg of active, three times a day. The posology for the treatment of iron deficiency anemia associated with renal pathologies remains the same, and it is recommended to subject the patient to regular checks.
For further information: see article on drugs for the treatment of iron deficiency anemia
Vitamin C and folic acid supplementation: also ascorbic acid and vitamin B9 can contribute to break down the symptoms that accompany iron deficiency anemia.
- Folic acid (eg Folina, Fertifol, Folidex): available both as soft capsules of 5 mg of active ingredient (to be taken 1-3 times daily), and as a solution for injection with 15 mg of folic acid (take once a day, intramuscularly).
- Vitamin C (eg Redoxon, Cebion, Cimille, Univit, C Tard, Agruvit, Univit, Duo C): indicatively, take 50-180 mg per day of vitamin C, orally, intramuscularly or intravenously. Do not exceed 180 mg of ascorbic acid per day.
It should be remembered, however, that the sole administration of vitamin C and folic acid, in the absence of vitamin B12, is not sufficient to treat pernicious anemia.
