비타민 B12의 투여 없이 호전된 악성 빈혈 1예
Spontaneous Remission of Pernicious Anemia
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
악성 빈혈은 위점막의 위축(gastric mucosal atrophy) 혹은위벽세포(parietal cell)의 자가면역성 손상으로 내인자(intrinsic factor)의 분비가 결핍되어 비타민 B12 (cobalamin) 흡수장애를 유발하고 결과적으로 거대적혈모구빈혈(megaloblastic anemia)이 발생하게 된다[1-3]. 악성 빈혈의 치료는 비타민 B12 결핍의 원인이 흡수 장애이기 때문에 비타민 B12를근육주사하는 것이 일반적이다[1]. 하지만 본 저자들은 악성빈혈로 진단된 후 특별한 치료 없이 비타민 B12 결핍이 호전된 증례를 경험하였기에 보고하는 바이다.
Abstract
Pernicious anemia is a macrocytic anemia that is caused by vitamin B12 deficiency, itself a result of the absence of intrinsic factors due to autoimmune destruction of parietal cells. We report here the case of a 43-year-old female with spontaneous remission of pernicious anemia. The patient presented with fatigue. Her serum vitamin B12 level was low, hemoglobin level was 7.6 g/dL, and serologic tests for anti-intrinsic factor and anti-parietal cell antibodies were positive. We diagnosed her with pernicious anemia, but did not administer vitamin B12 because her hemoglobin level increased spontaneously. Since then, the patient’s hemoglobin and serum vitamin B12 levels have been within the normal range.
참고문헌 (9)
- Jo DY, "Treatment of pernicious anemia", Korean J Med, 71, pp.237~240 (2006)
- Toh BH, "Pernicious anemia", N Engl J Med, 337, pp.1441~1448 (1997)
- Stabler SP, "Clinical practice. Vitamin B12 deficiency", N Engl J Med, 368, pp.149~160 (2013)
- Bunn HF, "Vitamin B12 and pernicious anemia--the dawn of molecular medicine", N Engl J Med, 370, pp.773~776 (2014)
- Span J, "A reversible case of pernicious anemia", Am J Gastroenterol, 88, pp.1277~1278 (1993)
- Wall AJ, "Prednisolone and gastric atrophy", Clin Exp Immunol, 3, pp.359~366 (1968)
- Jeffries GH, "The effect of prednisolone on gastric mucosal histology, gastric secretion, and vitamin B12 absorption in patients with pernicious anemia", J Clin Invest, 45, pp.803~812 (1966)
- Tanaka KR, "Spontaneous remission in pernicious anemia; report of a case", N Engl J Med, 258, pp.7~12 (1958)
- Herbert V, "Transient (reversible) malabsorption of vitamin B12", Br J Haematol, 17, pp.213~219 (1969)