Esteves Joana M, Fernandes Joana, Oliveira Monteiro Pedro, Almeida Mariana, Nogueira-Silva Luis, Almeida Jorge
Internal Medicine Department, Hospital Santa Maria Maior, Barcelos, Portugal.
Intensive Care Medicine Department, Centro Hospitalar e Universitário São João, Porto, Portugal.
Eur J Case Rep Intern Med. 2021 Mar 5;8(3):002357. doi: 10.12890/2021_002357. eCollection 2021.
Before the development of transfusion medicine, severe anaemia was an important cause of morbidity and mortality. The discovery of haematopoietic mechanisms and essential nutrients made it possible to easily treat and prevent this condition. Nevertheless, it is often fatal in patients presenting with extreme anaemia (haemoglobin levels <2 g/dl). We report the rare case of a 54-year-old woman who presented with profound megaloblastic anaemia (haemoglobin of 1.7 g/dl) due to vitamin B12 deficiency, and was successfully treated.
The discovery of vitamin B12 in the 20th century led to the successful and easy treatment of thousands of patients with anaemia.Focus on patient adherence to treatment and medical advice is essential in order to manage chronic conditions such as post-gastrectomy nutritional deficiencies.Extreme anaemia is very rare and associated with high mortality; treatment should be tailored to acute or chronic anaemia and in cases where haemodynamic stability is guaranteed, a restrictive blood transfusion strategy should be considered to reduce the risk of complications.
在输血医学发展之前，严重贫血是发病和死亡的重要原因。造血机制和必需营养素的发现使轻松治疗和预防这种情况成为可能。然而，对于出现极度贫血（血红蛋白水平<2 g/dl）的患者，它往往是致命的。我们报告了一例罕见病例，一名54岁女性因维生素B12缺乏出现严重巨幼细胞贫血（血红蛋白为1.7 g/dl），并成功接受治疗。
20世纪维生素B12的发现使数千名贫血患者得以成功且轻松地治疗。关注患者对治疗和医疗建议的依从性对于管理诸如胃切除术后营养缺乏等慢性病至关重要。极度贫血非常罕见且与高死亡率相关；治疗应根据急性或慢性贫血进行调整，在保证血流动力学稳定的情况下，应考虑采取限制性输血策略以降低并发症风险。
