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The aim of this work is to illustrate a difficult diagnostic in vitamin B12 deficiency because of using of multivitamin preparations to a patient with unknown etiology of anemia. History Patient: a 70 year old engineer, following 8 years vegetable – dietary, was admitted to the county hospital, in neurology department, with diagnostic of poli-radiculonevrites, received in ward the treatment with milgama (containing 250 micro-gram multivitamin). After a lipotimia status the patient was transferred to cardiology department. Laboratory examinations showed in peripheral blood: Hb = 6 3 g/dl; Ht = 18.8%; RBC= 290.000/mm³; PLT. = 214000/mm³; WBC = 5300/³mm; Ret. = 3, 7%; Erythrocytes indices = normal values; ESR = 38 mm/h, moderate increase and serum iron decreased, 36 microgram/dl value. On blood smear in optic microscopy was registered: Band = 5% (with nucleus in ring!!!), differential count being normally with aspect flags on Coulter HMX Analyzer with 22 parameters: neutrophilia, lymphopenia, anemia. To microscopic examination of slide from bone morrow, have occurred the hyperplasic series of erythrocytes ~ 45%, deficiency of erythropoiesis, poly-cromathopil and acidophil erythroblasts with megaloblastic character, large metamielocytes and giant band forms. Macrocytes and ovalocytes where also presented. Biopsy results from gastric mucosa showed lesions of chronic gastritis, non-atrophic epithelium. Conclusions: Megaloblastosis appears in some time with vitamin B12 deficiently in bone morrow but no in peripheral blood because of administration of multivitamin drugs, deleting haematological shape of megaloblastic anemia.
Anemia by Vitamin B12 and Latent Iron Deficiency
Anemia by Vitamin B12 and Latent Iron Deficiency
Healthcare and Medical Sciences
Vitamin B12 Deficiency >>Diagnosis >>Treatment
Vitamin B12 Deficiency
Vitamin B12 Deficiency
DJ CrissCross
haematopoitic vitamins and pathogenesis of megaloblastic anaemia
Haematopoitic vitamin,pathogenesis of megaloblastic anaemia by dr. Tasnim
Haematopoitic vitamin,pathogenesis of megaloblastic anaemia by dr. Tasnim
dr Tasnim
English version of my slideshare "anemia megaloblástica y otras anemias carenciales!
Anemia megaloblástica en
Anemia megaloblástica en
Eva Fraile
Vitamins biological properties along with their coenzyme forms are presented. Deficiency leading to diseases is discussed.Structure is given
Water soluble vitamins 2021 pptx
Water soluble vitamins 2021 pptx
Mahiraamirova1
Megaloblastic anemias
Megaloblastic anemias
adam once
Vitamin B12 is synthesized only by microorganisms and it is not present in plants Animals obtain the vitamin preformed from their natural bacterial flora or by eating foods derived from other animals Present in appreciable amounts in liver, red meat, fish, eggs , dairy products , and fortified cereals Required in humans for two essential enzymatic reactions Remethylation of homocysteine (Hcy) to methionine Isomerization of methylmalonyl coenzyme A (CoA), which is produced during the degradation of some amino acids (isoleucine, valine, threonine and methionine ) and fatty acids (FAs ) with odd numbers of carbon atoms DEFICIENCY When cobalamin is deficient, Fatty Acids accumulate and become incorporated into cell membranes , including those of the central nervous system (CNS) resulting in neurologic symptoms The physiologic coenzyme forms of cobalamin are 5'- deoxyadenosylcobalamin and methylcobalamin Folic acid (as N5-methyl THF) is also required in the remethylation of Hcy. Therefore , deficiency of B12 or folate results in elevated Hcy levels.
Cobalamin (vitamin b12) – Lippincott’s Illustrated Reviews World Wide Web
Cobalamin (vitamin b12) – Lippincott’s Illustrated Reviews World Wide Web
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Vitamin B 12 Deficiency
Vitamin B 12 Deficiency
Vitamin B 12 Deficiency
khalidmajidali
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The aim of this work is to illustrate a difficult diagnostic in vitamin B12 deficiency because of using of multivitamin preparations to a patient with unknown etiology of anemia. History Patient: a 70 year old engineer, following 8 years vegetable – dietary, was admitted to the county hospital, in neurology department, with diagnostic of poli-radiculonevrites, received in ward the treatment with milgama (containing 250 micro-gram multivitamin). After a lipotimia status the patient was transferred to cardiology department. Laboratory examinations showed in peripheral blood: Hb = 6 3 g/dl; Ht = 18.8%; RBC= 290.000/mm³; PLT. = 214000/mm³; WBC = 5300/³mm; Ret. = 3, 7%; Erythrocytes indices = normal values; ESR = 38 mm/h, moderate increase and serum iron decreased, 36 microgram/dl value. On blood smear in optic microscopy was registered: Band = 5% (with nucleus in ring!!!), differential count being normally with aspect flags on Coulter HMX Analyzer with 22 parameters: neutrophilia, lymphopenia, anemia. To microscopic examination of slide from bone morrow, have occurred the hyperplasic series of erythrocytes ~ 45%, deficiency of erythropoiesis, poly-cromathopil and acidophil erythroblasts with megaloblastic character, large metamielocytes and giant band forms. Macrocytes and ovalocytes where also presented. Biopsy results from gastric mucosa showed lesions of chronic gastritis, non-atrophic epithelium. Conclusions: Megaloblastosis appears in some time with vitamin B12 deficiently in bone morrow but no in peripheral blood because of administration of multivitamin drugs, deleting haematological shape of megaloblastic anemia.
Anemia by Vitamin B12 and Latent Iron Deficiency
Anemia by Vitamin B12 and Latent Iron Deficiency
Healthcare and Medical Sciences
Vitamin B12 Deficiency >>Diagnosis >>Treatment
Vitamin B12 Deficiency
Vitamin B12 Deficiency
DJ CrissCross
haematopoitic vitamins and pathogenesis of megaloblastic anaemia
Haematopoitic vitamin,pathogenesis of megaloblastic anaemia by dr. Tasnim
Haematopoitic vitamin,pathogenesis of megaloblastic anaemia by dr. Tasnim
dr Tasnim
English version of my slideshare "anemia megaloblástica y otras anemias carenciales!
Anemia megaloblástica en
Anemia megaloblástica en
Eva Fraile
Vitamins biological properties along with their coenzyme forms are presented. Deficiency leading to diseases is discussed.Structure is given
Water soluble vitamins 2021 pptx
Water soluble vitamins 2021 pptx
Mahiraamirova1
Megaloblastic anemias
Megaloblastic anemias
adam once
Vitamin B12 is synthesized only by microorganisms and it is not present in plants Animals obtain the vitamin preformed from their natural bacterial flora or by eating foods derived from other animals Present in appreciable amounts in liver, red meat, fish, eggs , dairy products , and fortified cereals Required in humans for two essential enzymatic reactions Remethylation of homocysteine (Hcy) to methionine Isomerization of methylmalonyl coenzyme A (CoA), which is produced during the degradation of some amino acids (isoleucine, valine, threonine and methionine ) and fatty acids (FAs ) with odd numbers of carbon atoms DEFICIENCY When cobalamin is deficient, Fatty Acids accumulate and become incorporated into cell membranes , including those of the central nervous system (CNS) resulting in neurologic symptoms The physiologic coenzyme forms of cobalamin are 5'- deoxyadenosylcobalamin and methylcobalamin Folic acid (as N5-methyl THF) is also required in the remethylation of Hcy. Therefore , deficiency of B12 or folate results in elevated Hcy levels.
Cobalamin (vitamin b12) – Lippincott’s Illustrated Reviews World Wide Web
Cobalamin (vitamin b12) – Lippincott’s Illustrated Reviews World Wide Web
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