Vitamin B12 malabsorption: causes, symptoms, diagnosis, treatment

There are several congenital forms of transport defects and absorption of cobalamin.

• Hereditary deficiency of the internal factor of Castle.
• Infringement of transport of cobalamin through an enterocyte (the Immersland-Gresbek syndrome).
• Deficiency of transcobalamin-2 (a carrier of cobalamin).

ICD-10 code

D51. Vitamin-B _{12 is a} deficiency anemia.

Symptoms

Symptoms of malabsorption of vitamin B ₁₂ develops from the first months of a child's life. They note weakness, pallor, delay in physical development, diarrhea. After 6-30 months after the onset of the first symptoms, neurological disorders are noted: mental retardation, neuropathy, myelopathy.

Acquired deficiencies of the vitamin (with resection of the stomach) are less severe and lack of neurological disorders.

Diagnostics

In the analysis of blood, in addition to megaloblastic anemia, there is pancytopenia, a violation of the functions of granulocytes with defects of humoral and cellular immunity. Sometimes it is mistakenly diagnosed with leukemia due to the discovery of immature precursors of leukocytes in the hypocellular bone marrow. The serum content of transcobalamin is usually within normal limits.

Treatment

Assign gidroksokobalamin in a high dose - 0.5-1.0 mg / kg daily until hematologic remission, and then 2 times a week. Folic acid is used for 15 mg orally 4 times a day. The use of folate without cobalamin in this disease is contraindicated.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13]