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Now I have two for you bumbaonline
1.-How many days, wks, month take to see an increase of RBC count after start the first dosage of B12????
2.- Treatment of Neonatal ketoacidosis??
bumbaonline Thx for ad flavor to the forum I have to go.
I am out..
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susan excellent ans of 2 ..hypersegmented neutrophil and methymalonate differentiates b12 and folate def blood picture
ans to adrian q
neonatal keto main thing you r looking for is the fluid i guess...its isotonic or half normal saline read details...http://emedicine.medscape.com/article/801117-treatment
Vit b12 adminstration requires 1 week to inc RBC count with daily IM dosage ...ret count checked evry 3 days ...reference john hopkins manual
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susan can u explain y PPI can cause vit B12 def.....
more common methtrexate
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B12 deficiency causes "macro Ovalocytes" while other causes of megaloblastic anemia just cause Megalocytes. Other causes of raised MCV include M6 type of AML, refratory anemia in myedlodysplasia.
Alcohol, Pyrimethamine, Methotrexate, anti epileptic drugs can also causes megaloblastic anemia.
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The reduced secretion of gastric acid and pepsin produced by PPIs can reduce absorption of protein-bound (dietary) vitamin B12, but not supplemental vitamin B12. Gastric acid is needed to release vitamin B12 from protein for absorption. Reduced vitamin B12 levels may be more common with PPIs than with H2-blockers, because they are more likely to produce achlorhydria (complete absence of gastric acid secretion). However, clinically significant vitamin B12 deficiency is unlikely, unless PPI therapy is prolonged (2 years or more) or dietary vitamin intake is low. Vitamin B12 levels should be monitored in people taking high doses of PPIs for prolonged periods.
