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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.