The concept of folic acid deficiency anemia
The daily adult requirementFolic acid is 0.4 mg, but the supply of folic acid in the body is limited. In this regard, under certain conditions, for example, within a few months increased utilization of folic acid (during pregnancy, lactation) develops its deficiency. Folic acid enters the body only from the outside.
Main sources - fruits and vegetables, especially spinach, lettuce, asparagus, broccoli, lima beans, melons and bananas. Folic acid deficiency - the most common cause of megaloblastic anemia.
Causes of folate deficiency:
- lack of food
- malabsorption of vitamins in the small intestine (jejunum resection or defeat her tumor, multiple diverticula, while tropical sprue, diphyllobothriasis, alcoholism)
- violation education biermerin - mukoproteidov involved in folic acid intake
- increased consumption of vitamins during pregnancy
- violation of vitamins of the deposit in diffuse liver disease (hepatitis, cirrhosis)
Development Mechanism and the main symptoms of anemia
At deficiency of cyanocobalamin (its coenzyme -methylcobalamin) there is no conversion of folic acid in its coenzyme form, without which it is impossible kompanenty synthesis, which is part of the DNA. As a result of impaired cell division and primarily affects actively proliferating cells of hematopoietic tissue. The bone marrow is delayed reproduction and maturation of red blood cells, shortening their life span.
As a result of violations of blood and hemolysis(Destruction) anemia erythrocytes, cells appear in which the blood cells with pathological features, and they appear not only in the bone marrow and blood. The changes concern, and white blood cells (leukopenia observed - reduction in the number of white blood cells) and thrombocytopenia (reduced platelet count).
The appearance and the appearance of improper mitosisgiant food channel epithelial cells leads to the development of inflammatory processes in the mucosa of its departments (stomatitis, esophagitis, gastritis, enteritis). This exacerbates the primary defect of secretion and absorption of intrinsic factor and, therefore, enhances vitamin deficiency (vicious circle).
As a result of the lack of cyanocobalamin inbody accumulates metabolic products that are toxic to nerve cells and nerve fibers in the fatty acids are synthesized with a modified structure. Develops degeneration (gradual qualitative change in cells) of the spinal cord (funicular myelosis), affects the cranial and peripheral nerves with the development of diverse neurological symptoms.
Treatment and prevention of anemia
For the prevention and treatment of folic acidfolic acid deficiency anemia administered at a dose of 1 mg / day orally. increase the dose if necessary. The number of young blood cells increases in 3-4 hours. Upon detection of neurological symptoms of B12 deficiency disease, should be deleted. When an unrecognized deficiency of this substance appointment of folic acid eliminates anemia, but neurological symptoms progress.
Prognosis is favorable. However, folic acid deficiency anemia in pregnant women may be accompanied by low volume of circulating blood and increase the risk of premature placental abruption, preterm birth and low birth weight. Folic acid deficiency - not the only reason for these complications. They may also be associated with poor nutrition during pregnancy.