DISEASES OF THE BLOOD SYSTEM : ANEMIA BIRNEROVA. PERNICIOUS ANEMIA (ANAEMIA BIERMERI, ANAFMIA PERNICIOSA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
In some cases the cause of the disease cannot be established. Has a value of infestation a lentetsom, the so-called botticella anemia - Botkin's disease, and syphilis, pregnancy. In the pathogenesis of this suffering, Botkin plays the role of a violation of the Central regulation of blood. Degenerative disorders gastro-intestinal tract, corresponding to the flora of the small intestines cause impaired barrier function of the intestinal wall permeable to certain protein products, toxic effects on the organism it is very likely. In Genesis characteristic of this suffering megaloblastic hematopoiesis is set deficit Antianemic agents.
C and m p t o m s. The main symptoms involving in pathological process of the blood forming organs (return to embryonic blood type - standard megaloblastic type). In the peripheral blood mark hyperchromic type of anemia, color index greater than one at the expense of megalocytes; in addition megalocytes, find megaloblastic; usually there are also standard and erythroblast (reticulocytes little). The degenerative nature of the violation from the red blood get the expression in aniso-poikilocytosis. White blood: leukopenia with relative limfotsitoz, monomania, eosinopenia. Platelet count decreased (trombopenia). Due to the presence of anemia and mild jaundice hemolytic type of skin and mucous acquire solomennoy color. The serum bilirubin is increased in comparison with the norm; number of serum cholesterol is reduced. In Calais the increased amount of urobilinogen is the final breakdown product of hemoglobin. All these data indicate an increased destruction of red blood cells. In urine there is a positive reaction to urobilin (indirect confirmation of the enhanced destruction of red blood cells). The spleen was increased in 50% of cases, the liver is 40%. Heart expanded (fatty infiltration), functional systolic murmur best listening at the apex of the heart h in a. pulmonalis. Gastro-intestinal fact the most common symptoms are: glossitis, reflected the emergence of language reddish wrong path itchy spots. Patients feel boleznennostew, burning tongue; with disease progression tongue becomes smooth (polished). Ahilya stomach organic (vitaminazienda) in 98% of cases. From the nervous system and psyche - adynamia. Paresthesias of the extremities, and in rare cases more pronounced symptoms funicular Milosa (lesion of the lateral and posterior columns of the spinal cord).
For chronic, cyclical, with periodic change of relapse under the influence of treatment remission.
Recognition - based consideration set forth.
In some cases we can talk about the clinical recovery and restoration almost complete disability. Remission provided a systematic treatment persist for years. The forecast is improving and in cases where the etiology is known; in such cases, the exile wide lentetsa or specifikace treatment leads to full recovery.