에이즈 환자에서 발생한 비타민 B12 결핍에 의한 거대 적혈모구 빈혈
Vitamin B12 Deficiency Megaloblastic Anemia in a Patient with Acquired Immunodeficiency Syndrome
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Anemia is the most common hematologic finding in patients with advanced infections caused by human immunodeficiency virus (HIV) or advanced acquired immunodeficiency syndrome (AIDS). Among many etiologies of HIVassociated anemia, vitamin B12 deficiency plays an important role, mostly due to malabsorption or HIV enteropathy. We experienced a case of megaloblastic anemia caused by vitamin B12 deficiency in a male patient with an AIDS who had no structural gastrointestinal problem. He showed severe anemia, leukopenia, thrombocytopenia and suspicious neurologic manifestations such as aggravation of dementia and gait disturbance. With vitamin B12 and folate treatment, the patient’s general condition and hematologic features were improved successfully.
Abstract
Anemia is the most common hematologic finding in patients with advanced infections caused by human immunodeficiency virus (HIV) or advanced acquired immunodeficiency syndrome (AIDS). Among many etiologies of HIVassociated anemia, vitamin B12 deficiency plays an important role, mostly due to malabsorption or HIV enteropathy. We experienced a case of megaloblastic anemia caused by vitamin B12 deficiency in a male patient with an AIDS who had no structural gastrointestinal problem. He showed severe anemia, leukopenia, thrombocytopenia and suspicious neurologic manifestations such as aggravation of dementia and gait disturbance. With vitamin B12 and folate treatment, the patient’s general condition and hematologic features were improved successfully.
참고문헌 (20)
- Kim JM, "Diagnosis and clinical manifestations of HIV", AIDS, 2007, pp.50, 303~315
- Zon LI, "Haematologic manifestations of the human immune deficiency virus (HIV)", Br J Haematol, 66, pp.251~256 (1987)
- Sullivan PS, "Epidemiology of anemia in human immunodeficiency virus (HIV)-infected persons: results from the multistate adult and adolescent spectrum of HIV disease surveillance project", Blood, 91, pp.301~308 (1998)
- Volberding PA, "Anemia in HIV infection: clinical impact and evidence-based management strategies", Clin Infect Dis, 38, pp.1454~1463 (2004)
- Oh R, "Vitamin B12 deficiency", Am Fam Physician, 67, pp.979~986 (2003)
- 송헌호, "비타민 B12 결핍성 거대적아구성 빈혈의 원인 분석 및 임상소견", 대한혈액학회지, 39(4), pp.243~248 (2004), 대한혈액학회
- Revell P, "Folic acid absorption in patients infected with the human immunodeficiency virus", J Intern Med, 230, pp.227~231 (1991)
- Remacha AF, "Vitamin B-12 abnormalities in HIV-infected patients", Eur J Haematol, 47, pp.60~64 (1991)
- Remacha AF, "Cobalamin deficiency in patients infected with the human immunodeficiency virus", Semin Hematol, 36, pp.75~87 (1999)
- Hepburn MJ, "Low serum vitamin B12 levels in an outpatient HIVinfected population", Int J STD AIDS, 15, pp.127~133 (2004)
- Kotler DP, "Enteropathy associated with the acquired immunodeficiency syndrome", Ann Intern Med, 101, pp.421~428 (1984)
- Gillin JS, "Malabsorption and mucosal abnormalities of the small intestine in the acquired immunodeficiency syndrome", Ann Intern Med, 102, pp.619~622 (1985)
- Herzlich BC, "Decreased intrinsic factor secretion in AIDS: relation to parietal cell acid secretory capacity and vitamin B12 malabsorption", Am J Gastroenterol, 87, pp.1781~1788 (1992)
- Kelly P, "Gastric and intestinal barrier impairment in tropical enteropathy and HIV: limited impact of micronutrient supplementation during a randomised controlled trial", BMC Gastroenterol, 10, pp.72~ (2010)
- Batman PA, "HIV enteropathy: crypt stem and transit cell hyperproliferation induces villous atrophy in HIV", Microsporidia-infected jejunal mucosa, 2007, pp.21, 433~439
- Bjarnason I, "Intestinal inflammation, ileal structure and function in HIV", AIDS, 10, pp.1385~1391 (1996)
- Burkes RL, "Low serum cobalamin levels occur frequently in the acquired immune deficiency syndrome and related disorders", Eur J Haematol, 38, pp.141~147 (1987)
- Harriman GR, "Vitamin B12 malabsorption in patients with acquired immunodeficiency syndrome", Arch Intern Med, 149, pp.2039~2041 (1989)
- 이꽃실, "국내 HIV 감염자에 있어서 항레트로바이러스 치료제의 부작용", Infection and Chemotherapy, 35(2), pp.71~77 (2003), 대한감염학회
- Hunter R, "Effect of folic-acid supplement on serum-vitamin-B12 levels in patients on anticonvulsants", Lancet, 2, pp.666~667 (1969)
