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Pathology
Vitamin B12 is required for DNA synthesis
Aetiology
Lack of gastric intrinsic acid for binding with dietary B12 or failure of absorption
in terminal ileum,. less often dietary deficiency (body stores last 2 -3 years)
Signs
Often none, pallor, CHF, peripheral neuropathy, confusion, Sub-acute Combined
Degeneration of spinal cord.Symptoms
Anaemia, neuropathy, bowel disease
Investigations
Bloods: FBC, serum B12 and Folate
Blood Film: Oval macrocytosis, hypersegmented neutrophils
Bone Marrow Biopsy: Serum ferritin, LDH, homocysteine levels
Treatment
Medical: Intramuscular hydroxocobalamin plus folic acid,
Prognosis
Symptomatic improvement within 24 hours when treated.
Overall prognosis is very good.
Neurological damage may be permanent
Key Facts
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Key Images
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Key References
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