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Pernicious anemia is the most common cause of vitamin B 12 deficiency anemia in adults, which results from malabsorption of vitamin B 12 due to a lack or loss of intrinsic factor. [2] [8] There are relatively few studies which have assessed the impact of haematological measures in response to B 12 supplementation.
[6] [15] [26] Vitamin B 12 deficiency can also cause symptoms of mania and psychosis. [27] [28] Among other problems, weakened immunity, reduced fertility and interruption of blood circulation in women may occur. [29] The main type of vitamin B12 deficiency anemia is pernicious anemia, [30] characterized by a triad of symptoms:
Imerslund–Gräsbeck syndrome is a rare autosomal recessive, familial form of vitamin B12 deficiency caused by malfunction of the "Cubam" receptor located in the terminal ileum. This receptor is composed of two proteins, amnionless (AMN), and cubilin. A defect in either of these protein components can cause this syndrome.
As a result of the concomitant vitamin and mineral deficiencies that occur as a result of the malabsorption associated with blind loop syndrome patients with advanced cases should be investigated for: [citation needed] Vitamin B12 deficiency; Folate deficiency; Iron deficiency; Vitamin E deficiency
Neuropsychiatric symptoms can precede hematological signs and are often the presenting manifestation of the disease. [55] Vitamin B 12 serum levels are used to detect its deficiency, but do not distinguish its causes. Vitamin B 12 levels can be falsely high or low and data for sensitivity and specificity vary widely.
Dietary deficiency of vitamin B 12 occurring in strict vegetarians and in their breastfed infants (isolated vitamin B 12 deficiency is very rare) Malabsorption of vitamin B 12 resulting from damage to the stomach, where intrinsic factor is secreted, or damage to the ileum, where intrinsic factor facilitates vitamin B 12 absorption.
The disease can also be caused by inhalation of nitrous oxide, which inactivates vitamin B12. [11] Vitamin E deficiency, which is associated with malabsorption disorders such as cystic fibrosis and Bassen-Kornzweig syndrome, [12] can cause a similar presentation due to the degeneration of the dorsal columns. [5]
Rare, occurring as a consequence of abnormalities in dietary fat absorption or metabolism, such as a defect in the alpha-tocopherol transport protein, rather than from a diet low in vitamin E. Vitamin K deficiency: Signs and symptoms can include sensitivity to bruising, bleeding gums, nosebleeds, and heavy menstrual bleeding in women. [50] [51]