Definition
Pernicious anemia delineates a particular form of anemia essentially associated with the deficiency of vitamin B12 (Cobalamine), caused in turn by a malabsorption of the same. Since vitamin B12 is essential for the growth of red blood cells, its deficiency causes a decrease in erythrocytes in the blood.
Causes
Autoimmune disease → atrophy of the gastric glandular mucosa → absence of intestinal intrinsic factor (useful for absorbing vitamin B12) → malabsorption of vitamin B12 → pernicious anemia
The possible triggering causes of pernicious anemia are: abuse of anti-ulcer drugs, surgical removal of the ileum or part of the stomach (sites of absorption of vitamin B12), celiac disease, vegetarian diet, H. Pylori infection, insertion of a bypass gastric, Crohn's disease.
Symptoms
Clinical evidence shows that patients with pernicious anemia have very high quantities of gastrin; in addition, the disease begins with altered perception of taste, increased serum levels of bilirubin, jaundiced skin, difficulty concentrating, atrophic glossitis (red and smooth lingual mucosa), irritability, headache, memory lapses. In severe cases, pernicious anemia involves the nervous system.
The information on Pernicious Anemia - Drugs for the Treatment of Pernicious Anemia is not intended to replace the direct relationship between a health professional and patient. Always consult your doctor and / or specialist before taking Pernicious Anemia - Drugs for the Treatment of. Pernicious anemia.
Medicines
If until recently pernicious anemia was included among the incurable and potentially lethal diseases, it is currently considered a treatable and fortunately not very widespread disease.
The therapy of choice is represented by the administration (generally, by intramuscular injection) of vitamin B12 which, as we have seen, is deficient in the patient with pernicious anemia.
Eventually, it is possible to complete the therapy with iron supplementation.
The following are the classes of drugs most used in the therapy against pernicious anemia, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and the dosage most suitable for the patient, based on the severity of the disease, the state health of the patient and his response to treatment:
Vitamin B12 supplementation: essential to ensure survival and the elimination of symptoms in patients suffering from pernicious anemia:
- Cyanocobalamin (eg. Tonocian, Disepavit, Epargriseovit): represents the drug of first choice for the treatment of pernicious anemia. Parenterally, start administering the drug at a dose of 100 mcg, intramuscularly, to be taken once a day for a week; in the case of a positive response, continue taking the drug every 2 days (for 7 days); then administer the active ingredient every 3-4 days for another 2-3 weeks. In general, most patients with anemia pernicious requires monthly administration of the drug at a dose of 100-1,000 mg intramuscularly for life. Alternatively, cyanocobalamin can be taken in the form of a nasal spray or nasal gel (500 mcg in one nostril, once a week) , only when pernicious anemia does not involve the nervous system.
- Cobamide (eg Cobaforte): indicated for the treatment of pathologies characterized by a deficiency of vitamin B12, including pernicious anemia. The drug is an enzymatic form of vitamin B12 which, protected by intrinsic factor, is subsequently absorbed in the duodenum. Available as 2.5 mg capsules, it is recommended to take 2 capsules per day.The drug can also be administered intramuscularly when vitamin B12 deficiency is particularly severe.
Iron supplementation: sometimes, the patient with pernicious anemia may also need iron salts supplementation:
- Ferrous sulphate (eg Ferrograd): antianemic par excellence, ferrous sulphate is widely used in martial therapy (iron deficiency anemia). Typically, the drug is available in the form of controlled-release tablets with 595 mg of active. It is recommended to take 1 tablet a day, with water. The drug requires a prescription. To improve absorption, it is recommended to take the drug with vitamin C (eg with a glass of orange juice).
- Iron fumarate (eg. Organic Iron): start therapy for iron deficiency anemia with 325 mg of drug orally, once a day. Continue with maintenance therapy by taking 325 mg of active, three times a day. The posology for the treatment of iron deficiency anemia associated with kidney disease remains the same, and it is recommended that the patient be subjected to regular checks.
For further information: see article on drugs for the treatment of iron deficiency anemia
Integration of vitamin C and folic acid: ascorbic acid and vitamin B9 can also help to reduce the symptoms that accompany iron deficiency anemia.
- Folic acid (eg. Folina, Fertifol, Folidex): available both as soft capsules of 5 mg of active ingredient (to be taken 1-3 times a day), and as a solution for injection of 15 mg of folic acid (taken once a day , intramuscularly).
- Vitamin C (eg. Redoxon, Cebion, Cimille, Univit, C Tard, Agruvit, Univit, Duo C): indicatively, take 50-180 mg per day of vitamin C, orally, intramuscularly or intravenously. Do not exceed 180 mg of ascorbic acid per day.
It should be remembered, however, that the sole administration of vitamin C and folic acid, in the absence of vitamin B12, is not sufficient to cure pernicious anemia.
