Learn about the mechanism behind the macrocytic anemias in this video. For more information, look at Robbins and Cotran: Pathological Basis of Disease, Chapter 14.
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@jameskingsley89528 жыл бұрын
Thank you for your clear and concise presentation! The VitB12 pathway, however is a little over simplified with some clinical implications. So the R-binder produced in the mouth binds to B12 and travels into the stomach. Parietal cells in stomach produce IF and IF travels unbound B12-RBinder complex into the duodenum where pancreatic proteases break apart B12-RBinder complex in which case IF binds to B12 and is eventually absorbed in the terminal ileum like you mentioned by transcobalamin. This is important because the reason why short bowel syndrome (post small bowel resection) and pancreatic insufficiency are causes of macrocytic anemia/vitB12 deficiency is because the pancreatic enzymes are inactivated in the pathologically acidic environment of the duodenum (in the case of short short bowel syndrome) or are prematurely activated/blocked from getting to the duodenum. So two important causes of vitb12 deficiency and macrocytic anemia are pancreatic insufficiency and short bowel syndrome - which are more common than pernicious anemia and will be apart of more challenging board questions. Also - don't forget chronic liver disease i.e. cirrhosis as being a cause of macrocytic anemia as well - because these patients if they have a slow variceal bleed their MCV will not necessarily be microcytic - it might be normocytic - in which case you depend on RDW for help.
@lisagonzalez29026 жыл бұрын
It was excellent. The best video i could find on specifically megaloblastic anemia. you described everything in a simple way. thanks a lot
@hepdrip9 жыл бұрын
This is a wonderful teaching tool.
@runswithwands6 жыл бұрын
I was recently diagnosed with megaloblastic macrocytic anemia. I'd been borderline anemic for a couple decades, but this seemed to come full bore recently. I had memory loss issues--both short and long term--and I could not figure out what happened. I decided the Minocycline I'd been on for 2+ years may have contributed somehow to all of this: long-term loss to good flora in the gut, vulnerability sets in, and here I am having to deal with macrocytic anemia. I recently dropped the Minocycline and am hoping that, once my body returns to a more normalized state, that the anemia goes away. In the meantime, supplements and my doctor are supportive and helping me figure this out. Thank you for the video. While Minocycline may not be a common answer, I think it is the reason I have gone downhill with anemia, quite hard, in the past couple years. I just had to put two and two together. :)
@efifenning2 жыл бұрын
For me was PPI medication and under active thyroid together.
@samson14349 жыл бұрын
These videos are awesome!! THANKS!
@Knuxsega8 жыл бұрын
Your information is very conceptual and thorough.. Thanks a bunch daf189!! :D
@luciamartin64449 жыл бұрын
thank you so much for this wonderful explanation.
@24carrotgold8 Жыл бұрын
I have the MTHFR mutation. The females in my family manifest with multiple miscarriages. I have never tried to conceive so even though I have the defect I wasn't sure how it would manifest. Unfortunately I metastasized endometrial cancer after surgical removal of all my reproductive organs. It was during chemotherapy that my RBC steadily declined and combined with my elevated RDW% created the megaloblastic anemia. I am now taking an OTC folate and B12 pill combo recommended by my niece's doctor. I believe the chemo did not cause the problem but it gave the MTHFR mutation the opportunity to manifest. 😥
@JEDDAHBOYS57 жыл бұрын
keep it up man you are very good , thank you
@Carlitoboyhey6 жыл бұрын
Nice speed and easy done
@drg90437 жыл бұрын
What software and hardware have you used?
@AnotherBadyoga7 жыл бұрын
Great videos! As good or better than the Khan Academy (which I like but sometimes the lectures talk to slow).
@manjushreeinamdar12422 жыл бұрын
WHY DID U STOP MAKING THESE VIDEOS!! PLS COME BACK. WE NEEEED YOU GEEENIUSSSS!!!
@user-dq4gl1vt9f7 жыл бұрын
thank you so much sir
@zSchreckensszene3 жыл бұрын
causes of - folate deficiency: malnutrition (not enough green leafy FOLIAGE), treated by oral folic acid - B12 deficiency: treated parenterally (anything that's not enterally, or GI wise): B12 also breaks down FAs, so if it's not there then myelin suffers --> peripheral neuropathy! -- resection -- tapeworm -- decreased intrinsic factor: IF is released by the parietal cells. if they're being destroyed in autoimmunity, that's called "pernicious aniemia)
@brucemattingly6476 Жыл бұрын
Great summary..! Folic Acid is inactive and needs to be converted into Methyl Folate. I would supplement with Methyl Folate in case individual has MTHFR polymorphism which doesn't allow them to convert Folic Acid into Methyl Folate. 🫤
@MichaelsUgly7 жыл бұрын
Vit B12 def -> peripheral neuropathy
@amolbirajdar65097 жыл бұрын
Thanx
@user-gp5mw6eh4o2 жыл бұрын
macrocytic anemia or megaloplastic anemia hyper cromic mcv 100-120 normality B12. folic acid disease liver faction thyroid disease thanke very much 🌹🌹
@queenmaria52522 жыл бұрын
I must appreciate Dr Anii on KZfaq for helping me in getting rid of my genital Herpes virus, right Now I am totally cured
@nellyhoffman61948 жыл бұрын
Wow amazing lectures brother !! :) thanks very much but if you can speak slowly ! :p Good luck keep going
@mizmac2029 жыл бұрын
Question, sir. You said that the body needs intrinsic factor in order to absorb the vit B12 in the gut. So how come the parenteral B12 itself treats the pernicius anemia that is caused by decreased intrinsic factor in the gut, knowing that there's only few intrinsic factor that will bind to B12?
@daf1899 жыл бұрын
Good question. Pernicious anemia is a specific case of macrocytic anemia, caused by not absorbing B12 due to a lack of intrinsic factor. The lack of intrinsic factor is not what causes the anemia - it is the lack of B12. Not having intrinsic factor means the body cannot absorb the B12, which causes the anemia. Getting B12 into the body parenterally bypasses the need for intrinsic factor, as the B12 is injected into the body directly, where it can be used to help build normal RBCs. I hope that helps.
@mizmac2029 жыл бұрын
daf189 owwww! yeah! B12 will be given PARENTERALLY so it doesn't need to pass through the GI. Hence, no need for intrinsic factor and everything XD hahahha! what a stupid question XD Anyways, thank you so much, sir. This video helped me a lot. Sorry about the nuisance..
@daf1899 жыл бұрын
Marielle Cabie no problem - im glad it makes sense now!
@otaribeldishevski9487 жыл бұрын
Other causes of macrocytic anemia? Hypothyroidism? Liver disease? Acute bleeding?
@KLTees7 жыл бұрын
Yes. . . Liver disease, Alcoholism , Bone Marrow infiltration , Hypothyroidism , Cytotoxic drug therapy , COPD, Scurvy ,etc can cause Normoblastic Macrocytic Anaemia
@fatimafernandes26604 жыл бұрын
I'm on hiv aids drugs can this also cos this in my case doc?????
@MedicAbbas3 жыл бұрын
it depends on what medicinal drugs are being used as part of your treatment.
@SmoDesign6 жыл бұрын
RBCs don’t have genetic materials, how come it goes through the check points cycle? or even why do we explain that macrocytic anaemia is due to “bad DNA”?
@ikram23266 жыл бұрын
Yes Rbc don't have gentic material but that's when it reaches the last stage of the erythropoises (the process of rbc production ). But it contains a nucleus DNA and mitochondrial DNA during the very early stages of the cell's life, and the nucleus is ejected as a normal part of cellular differentiation before the cell is released into the bloodstream. And the DNA is what helps the cell to divide. But only after it reachs the normoblast stage it looses the nucleus and the DNA.
@SmoDesign6 жыл бұрын
اكرام عبدالله thank you
@mindheartandsoul19219 жыл бұрын
hmmm... someone needs to fix this... info is incorrect.