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Impaired absorption celiacs disease crohns disease

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Impaired Absorption – Celiac’s Disease, Crohn’s Disease; parasite infections---absorb the vitamin *Lack of intrinsic factor – allows B 12 to go thru stomach, made by parietal gastric cells, combines w/ B 12 and gives it safe passage thru stomach (stomach pH = 2 ; normal body pH = 7.4) Destroyed if not bound to intrinsic factor Lack of intrinsic factor----malabsorption of B 12 ------causes pernicious anemia (a lack of B 12 b/c no intrinsic factor)
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EXAM III MATERIAL Autoimmune Disorder---anti panel antibodies – antibodies attack parietal cells – inflammation and destruction of cells – no intrinsic factor If lacking intrinsic factor – have to get B 12 via shots B 12 stays in your body for a long time – it can be stored B 12 produces energy (ATP); a part of DNA Pg. 253 Competition for B 12 (Malaborption) Tape worm Hereditary Transcobolomy – rare, if unrecognized concerned w/ brain----cobolomy= B 12 name B 12 and Folate Pancytopenia – lack of all cells; decreased Hg, HCT; MCV high; RDW elevated; oval macrocytes; absolute reticulocyte count low so polychromasia not seen – you may see nucleated RBCs tho; hyperseg of neutrophils; if large red cells and hypersegmented neutrophils=megaloblastic anemia (large blast) white cells are sometimes larger; can get an increase in bilirubin and LDH Specific Diagnostic Tests--- 1 st B 12 and folate tests---then bone marrow – you’ll see very large megaloblasts; can do a gastric analysis to look for pernicious anemia (not done too much); can do antibody assays to look for anti-parietal cells; Schilling Test – looks for malabsorption – common in radiology; given pill w/ radioactive B 12 then a shot of B 12 – see how much radioactive anemia is eliminated----pernicious anemia; Stool analysis for parasites---look for eggs (ova – parasite) Trx----increase dietary folate; increase dietary B 12 ; B 12 shots Another Macrocytic Anemia
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