Megaloblastic anemia ´ëÀå°æ Á¤¸®
1. vit B12 ¼ö¼Û´Ü¹éÁú: gastric R receptor, IF, transcobalamin II
2. pernicious anemia¿¡¼ ¸é¿ªÇÐÀû ÀÌ»óÀÌ µ¿¹ÝµÈ´Ù´Â Áõ°Å 4°¡Áö
¾Ï±â: ´Ù¸¥¸é¿ªÀÌ»óÀÌ Àִ ȯÀÚ °¡Á·ÀÇ Ç×ü ¾ç¼º·üÀÌ ³ô´Ù)
i) ´Ù¸¥ ¸é¿ªÇÐÀû ÀÌ»óÀÌ Àִ ȯÀÚ¿¡¼ ºóµµ°¡ ³ô´Ù.
Graves' ds, myxedemia, thyroiditis, vitiligo, hypoparathyroidism
ii) abnormal circulating antibody
anti-parietal Ab(90%), anti-IF Ab(60%)
iii) ȯÀÚÀÇ °¡Á·¿¡¼ À¯º´·üÀÌ ³ô°í, ÀÓ»óÀûÀ¸·Î º´ÀÌ ¾ø´Â °¡Á·¿¡¼µµ anti-IF Ab°¡
¹ß°ßµÈ´Ù.
iv) corticosteroid Ä¡·á½Ã º´À» È£Àü½ÃŲ´Ù´Â º¸°í°¡ ÀÖ´Ù.
3. pernicious anemiaÀÇ autoantibody
i) anti-parietal cell Ab(90%)
ii) anti-iF Ab(60%)
iii) anti-thyroid Ab(50%)
4. megaloblastic anemia¶§ÀÇ ½Å°æÇÐÀû Áõ»ó
vit B12 deficiency¶§¸¸ ³ªÅ¸³ª°í ´Ù¸¥ ¿øÀÎÀÇ megaloblastic anemia¶§´Â ½Å°æÇÐÀû Áõ»óÀÌ
¾ø´Ù.
5.
6. vit B12 deficiency¿¡¼ ºóÇ÷ÀÇ Á¤µµ¿Í ½Å°æÇÐÀû ÀÌ»óÁ¤µµ´Â ºñ·ÊÇÏÁö ¾Ê´Â´Ù.
neurologic manifestationÀº methionineÀÇ »ý¼º°¨¼Ò¿Í methylmalonyl CoA ÃàÀû ¶§¹®ÀÌ´Ù.
7. vit B12 deficiency: Ä¡·á½Ã BM morphology´Â ¼ö½Ã°£¸¸¿¡ ȸº¹µÇ±â ½ÃÀÛÇÏ¿©
reticulocytosis´Â 4ÀϰºÎÅÍ Áõ°¡ÇÏ¿© 7Àϰ peak
±×ÈÄ ¼öÁÖ¿¡ °ÉÃÄ ºóÇ÷ÀÌ È¸º¹µÈ´Ù.
* Ä¡·á½Ã hypokalemia, sodium retentionÀÌ »ý±æ¼ö ÀÖ´Ù.