Pernicious Anemia - Mitch
Transcript of Pernicious Anemia - Mitch
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PERNICIOUS
ANEMIA
Prepared by:Michelle Anne
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PERNICIOUS ANEMIA
Historical View:
First described in 1849 by Thomas Addison
Was termed fatal and called Pernicious due to
similar symptoms found in Leukemia and Cancer. Dr. George Whipple produced the first cure
for PA which is raw liver.
In 1948 Vitamin B12 was introduced as the main
source of cure of PA patients. Today, the term pernicious is no longer appropriate,
but it is retained for historical reasons
http://www.b12patch.com/blog/wp-content/uploads/2012/01/raw_pork_liver_elevated_view_mu00133.jpghttp://www.b12patch.com/blog/wp-content/uploads/2012/01/5726696933_9fc93893d9.jpg -
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PERNICIOUSANEMIA
A.K.A:1. Macrocytic Achylic Anemia
2. Congenital / Juvenile Pernicious Anemia
A rare autosomal recessive indicated as early onset and
presents before age 2 with significantly decreased lowlevels of IF but normal gastric secretions.
3. Megaloblastic Anemia
characterized by the presence of enlarged cells(megaloblasts) due to the impaired cell division
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Definition: A chronic illness caused by impaired absorption of
vitamin B-12 due to a lack of intrinsic factor (IF) inthe stomach.
An adult onset but usually diagnosed around theage of 60
PERNICIOUSANEMIA
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PERNICIOUSANEMIA
Intrinsic Factor: A glycoprotein secreted by
the parietal cells in thestomach lining
Facilitates absorption ofvitamin B12 in the smallintestine
Vitamin B12: Necessary in the formation
of red blood cells
Maintenance of the centralnervous system
Is important for metabolism
Can be found in:
Eggs, meat, shellfish,milk, orange, broccoli,
asparagus, green leafyvegetables, peas,peanuts, beanschickpeas
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PERNICIOUSANEMIA
Causes: Weakened stomach lining (atrophic gastritis)
The body's immune system attacking the cells thatmake intrinsic factor or intrinsic factor itself
Long term use of certain drugs that can reduce theacid in the stomach lining such as metformin, andbiguanides.
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PERNICIOUSANEMIA
Lack of Vitamin B12 in the diet which is
common among vegetarians.
From certain intestinal disorders that interfere with theabsorption of vitamin B12, such as Crohn's disease andintestinal infections.
Surgery such as Gastrectomy or Gastric Bypass for
weight loss
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PATHOPHYSIOLOGY
Precipitating factors:Diet
Surgery Drugs affecting the absorption of vitaminB12
Lack of intrinsic factor in the stomach
Decrease in Vitamin B12
Abnormal red blood cell (Macrocytic)
Hypoxia Pallor
Fatigue Pale nail bed Loss of appetite
Disorientation Irritability
Personality changesDementia
DizzinessHeadacheDiarrheaPoor concentrationShortness of breathWeaknessAltered tasteperception
Beefy red tongue Depression
Loss of balance Memory loss shortterm Numbness or tinglingsensation in arms orlegs
Pernicious Anemia
Weakened gastric lining loss of parietalcells
Decrease in production of Red Blood Cells
Predisposing factors:Age
Race Family History Autoimmune Disorders
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PERNICIOUSANEMIA
Symptoms: Dizziness
Pallor
Fatigue, lack of energy
Diarrhea or constipation
Loss of appetite
Problems concentrating
Shortness of breath
Beefy red tongue - pathognomonic
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PERNICIOUSANEMIA
Numbness and tingling of hands and feet
Personality changes
Confusion
Short term memory loss
Dementia Depression
Loss of balance
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PERNICIOUSANEMIA
Diagnostic tests: Complete blood count (CBC)
Reticulocyte count
Serum vitamin B12 level
Bone marrow examination
Schilling test
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PERNICIOUSANEMIA
Treatment: IM B-12 at 1000 mcg daily for one week, then 1000 mcg
weekly for one month, then 1000 mcg every month forone year indefinitely.
Some doctors recommend that elderly patients withgastric atrophy take vitamin B12 supplements by mouthin addition to monthly injections.
There is also a preparation of vitamin B12 that may begiven through the nose.
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PERNICIOUS ANEMIA
Nursing interventions:1. Plan activities, rest periods, and necessary diagnosis
test to conserve the patient energy
2. Monitor pulse rate often.
3. For adequate schilling test results, all urine over 24 hrsperiod should be collected and the specimen notcontaminated with feces
4. Warn the patient to guard against infections and toreport signs of infection promptly
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PERNICIOUSANEMIA
5. Provide well balanced diet, including foods high invitamin B12
6. Avoid giving irritating food since the patients mouthand tongue are sore and painful
7. Warn the patient with sensory deficit not to use aheating pad since it may cause burn
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PERNICIOUSANEMIA
Prognosis:
Pernicious anemia is usually easy to treat with vitaminB12 pills or shots
People with pernicious anemia who get proper lifelongtreatment can have a normal lifespan.
Complications:
People with pernicious anemia may have gastric polyps,and they are at increased risk for gastric cancer and
gastric carcinoid tumors.
Brain and nervous system (neurological) problems maycontinue if treatment is delayed.
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PERNICIOUS ANEMIA
Conclusion:Pernicious anemia is common among the aging.
The disease is a result of impaired absorption ofVitamin B12 due to a deficiency of Intrinsic Factor.
The cause is unknown; it affects multiple systems ofthe human body but if recognized and treated early,all effects are completely reversible.
Although the treatment is lifelong, it is relatively
simple and convenient to the patient.
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