Saturday, February, 11, 2012

Pernicious anemia

Table of Contents

Alternative Names

Macrocytic achylic anemia; Congenital pernicious anemia; Juvenile pernicious anemia; Vitamin B12 deficiency (malabsorption)


Symptoms

People with mild anemia may have no symptoms or very mild symptoms. More typical symptoms of vitamin B12 deficiency anemia include:

  • Diarrhea or constipation
  • Fatigue, lack of energy, or light-headedness when standing up or with exertion
  • Loss of appetite
  • Pale skin
  • Problems concentrating
  • Shortness of breath, mostly during exercise
  • Swollen, red tongue or bleeding gums
  • Nerve damage caused by vitamin B12 deficiency that has been present for a longer time may cause:
    • Confusion or change in mental status (dementia) in severe or advanced cases
    • Depression
    • Loss of balance
    • Numbness and tingling of hands and feet

Signs and tests

Tests that may used to diagnose or monitor pernicious anemia include:

  • Bone marrow examination (only needed if diagnosis is unclear)
  • Complete blood count (CBC)
  • Measurement of serum holotranscobalamin II
  • Reticulocyte count
  • Schilling test
  • Serum LDH
  • Serum methylmalonic acid (MMA) level
  • Serum vitamin B12 level

Pernicious anemia may also affect the results of the following tests:

  • Bilirubin
  • Cholesterol test
  • Gastrin
  • Leukocyte alkaline phosphatase
  • Peripheral smear
  • TIBC

Vitamin B12 deficiency affects the appearance of cells that form on the outer surface of the body and line inner passageways (epithelial cells). An untreated woman may have a false positive Pap smear.


Review Date: 02/01/2010
Reviewed By: David Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)