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...vitamin B12 deficiency secondary to atrophic gastritis caused by H. pylori. After successful treatment of H. pylori and initiation of both intramuscular injection and oral administration of vitamin B12, glossitis and anaemia improved within 1 month
Megaloblastic anemia (MA) encompasses a heterogeneous group of macrocytic anemias characterized by the presence of large red blood cell precursors called megaloblasts in the bone marrow.[1] This condition is due to impaired DNA synthesis, which inhibits nuclear division. Cytoplasmic maturation, mainly dependent on RNA and protein synthesis, is less impaired. This leads to an asynchronous maturation between the nucleus and cytoplasm of erythroblasts, explaining the large size of the megaloblasts.[2] The process affects hematopoiesis as well as rapidly renewing tissues such as gastrointestinal cells. Megaloblastic anemia is most often due to hypovitaminosis, specifically vitamin B12 (cobalamin) and folate deficiencies, which are necessary for the synthesis of DNA.[3] Copper deficiency and adverse drug reactions (due to drug interference with DNA synthesis) are other well-known causes of megaloblastic anemia. A rare hereditary disorder known as thiamine-responsive megaloblastic anemia syndrome (TRMA) is also identified as a cause of megaloblastic anemia.[4] The list of drugs associated with the disease is long however, frequently implicated agents include hydroxyurea, chemotherapeutic agents, anticonvulsants, and antiretroviral therapy (ART) drugs.
Valproic acid (Depakote, divalproex), commonly used for bipolar disorder, is a known inhibitor of folic acid. There is evidence that folate consumption is protective.
Evidence for increased catabolism of vitamin B-6 during systemic inflammation - PubMed
Broad-specificity enzymes upregulated to reduce oxidative and aldehyde stress could explain increased catabolism of vitamin B-6 during inflammation. The ratio PA:(PL + PLP) may provide novel insights into pathologic processes and potentially predict risk of future disease.
Sarcopenia is the gradual loss of muscle mass, strength and function. The condition commonly affects the elderly population and is thought to occur due to aging.
Sarcopenia (ICD-10-CM code M62.84[1]) is a type of muscle loss that occurs with aging and/or immobility. It is characterized by the degenerative loss of skeletal muscle mass, quality, and strength.
Cachexia (/kəˈkɛksiə/ ⓘ[1]) is a syndrome that happens when people have certain illnesses, causing muscle loss that cannot be fully reversed with improved nutrition.