Deficiency of vitamin B12, folic acid and some internal factors can slow down the playback of erythroblasts in the bone marrow. As a consequence, erythroblasts increase in size and take on an unusual shape. These are called erythroblasts megaloblasts.

The role of vitamin B12

The role of vitamin B12 and folic acid Folic acid - the value is hard to overestimate   in the development of megaloblastic anemia is associated with their participation in a wide variety of metabolic processes, and exchange reactions in the body. B12 is a cofactor for a catalytic reaction metiltrasferaznoy performing resynthesis methionine and simultaneously regenerating the 5-methyltetrahydrofolate and tetrahydrofolate to 5, 10 methylenetetrahydrofolate.

At insufficiency of folate and vitamin B12 disturbed the process of inclusion of uridine in the DNA of developing cells and gemopoetichekih formation of thymidine, which leads to DNA fragmentation (blocking its synthesis and disruption of cell division). When this occurs megaloblastoz, there is an accumulation of large leukocytes forms White blood cells as the basis of immunity   and platelets Platelets - what they are for the body? Their earliest intramedullary destruction and shortening life of circulating blood cells. As a result, ineffective hematopoiesis, anemia, combined with thrombocytopenia and leukopenia.

In addition, vitamin B12 is a coenzyme in the conversion reaction of methylmalonyl-CoA to succinyl-CoA. This reaction is necessary for the metabolism of myelin in the nervous system, and therefore the deficiency of vitamin V12a along with megaloblastic anemia Anemia - when you do not have enough blood   It celebrated the defeat of the nervous system, while during folate deficiency is observed only the development of megaloblastic anemia.

Where is Vitamin B12

Vitamin B12 is found in foods of animal origin - the liver, kidney, eggs, milk .  Stocks of it in the body of an adult (mainly in the liver) are large - about 5 mg, and if we take into account that the daily loss of vitamin is 5 mg, the complete depletion of the absence of revenues (malabsorption, with a vegetarian diet) comes only in 1000 days .  Vitamin B12 in the stomach is associated (in the background of an acid reaction medium) with an internal factor - a glycoprotein produced by the parietal cells of the stomach, or other binding proteins - R-factors are present at in saliva and gastric juice .  These complexes protect vitamin B12 from destruction during the transport of the digestive tract .  In the small intestine at an alkaline pH influenced pancreatic juice proteases B12 cleaved from R-proteins and binds to intrinsic factor .  In pdovzdoshnoy intestine complex of intrinsic factor with vitamin V12om binds to specific receptors on the surface of epithelial cells, the release of vitamin V12a of intestinal epithelial cells and transport to tissues occurs via specific plasma proteins - transcobalamin 1, 2, 3, the transport of vitamin B12 for hematopoietic cells is carried out mainly Transcobalamin 2 .

Folic acid is found in green leaves of plants, fruits, liver, kidneys. Stocks of folate are 5-10 mg, the minimum requirement - 50 micrograms per day. Megaloblastic anemia can develop after 4 months of receipt of a complete lack of folate from food.

Causes megaloblastic anemia

Various factors can cause a deficiency of vitamin B12 or folic acid (sometimes combined failure of both) and the development of megaloblastic anemia.

Deficiency of vitamin B12 can cause the following reasons:

• Low levels of vitamin B12 in the diet;
• vegetarianism;
• Low absorption;
• shortage of intrinsic factor;
• pernicious anemia;
• gastrectomy;
• damage to gastric epithelial chemicals;
• infiltrative changes in the stomach (carcinoma or lymphoma);
• Crohn's disease;
• resection of the ileum;
• atrophic processes in the stomach and intestine;
• increased utilization of vitamin B12 by bacteria in their excessive growth;
• after the imposition of the state of the gastrointestinal anastomosis;
• intestinal stasis or obstruction due to strictures;
• parasitic infestation;
• a tapeworm;
• tuberculosis of the ileum;
• lymphoma of the small intestine;
• sprue;
• regional enteritis;
• other causes.
• malabsorption due to the use of neomycin colchicine.

Hemoglobin - a red pigment of blood. It consists of two components: the globin specific simple protein (96%), and the remaining 4% of which are non-specific prosthetic group, iron-containing pigment, called "heme", a connection to the ferrous iron. Hemoglobin carries oxygen from the lungs to body tissues and returns from the tissues to the lungs carbon dioxide. The high level of hemoglobin is characterized by an excess of red blood cells for a specific person of a certain age and gender. The hemoglobin level rises gradually and imperceptibly. Most often, this condition occurs in men over the age of forty years.

Major diseases

This condition indicates an increase in the number of red blood cells, which occurs as a result of blood hyperviscosity syndrome, which in turn impairs the transportation of oxygen to the tissues. In addition, blood flow is blocked, and starts congestion in the capillary vessels. Occlusion leads to the appearance of signs of peripheral vascular disease, and thrombotic and hemorrhagic complications continue to ischemic pain in the limbs, and possibly to gangrene. Thrombotic complications manifested as arterial and venous thrombosis. Arterial thrombosis, in turn, leads to angina pectoris, myocardial infarction, pulmonary infarction, thrombosis Thrombosis - the cause of heart attack and stroke   cerebral vascular thrombosis and arteries. Venous thrombosis is thrombosis of hepatic or mesenteric veins. There may also be thromboembolic complications.

Hemorrhagic episodes

Bleeding gums, nosebleeds, blood in the urine Blood in the urine - a reason for serious concern , Gastrointestinal bleeding as vomiting with blood and tarry stools - complications, most often occurring in patients.

Abdominal pain

The cause of abdominal pain Abdominal pain: Types and Symptoms   splenic infarction may be, it is a process of tissue necrosis resulting from insufficient blood supply, kidney or heart attack.

Goutiness

It is a condition characterized by susceptibility to gout or development ofiaza or sodium urate deposition due to increased uric acid in the blood. Common features of the disease include pain and swelling of joints, renal colic due to the presence of uric acid kidney stones, and / or ureter and urate nephropathy, which is an autoimmune disease, kidney damaging.

Respiratory tract infections

Intercurrent infections, particularly respiratory infections, such as bronchitis, which leads to chronic bronchitis, ultimately, to the development of emphysema, chronic respiratory disease.

Splenomegaly

In most cases, that is 75%, the spleen is increased by hyperplasia Hyperplasia - do not be afraid   (cell proliferation tissue or organ) pulp and expanded by filling with blood. More often it leads to a heart attack of the spleen.

Other threats

With the progression of the disease is the proliferation of fibrous tissue, and the disease can develop into myelofibrosis, a serious disease of the bone marrow, which disrupts the normal production of red blood cells in the body. Less often the result is the development of acute myeloid leukemia, chronic myeloid leukemia as a result of degeneration observed in chronic myeloproliferative disorders.