Pernicious anemia (or Addison-Biermer disease) is anemia resulting from vitamin B12 deficiency. It is a rare disease and usually affects people between the ages of 40 and 60. Interestingly, it is most common in people with blood group A. Check the causes and symptoms of pernicious anemia. How is vitamin B12 deficiency anemia treated? What tests should be performed to recognize it?

Pernicious anemiabelongs to the group of megaloblastic anemia, which is the most common cause of vitamin B12 deficiency anemia in adults. What are hercausesandsymptoms?How is thetreatmentof patients struggling with this disease?

Pernicious anemia - causes of vitamin B12 deficiency anemia

The cause of pernicious anemia is autoimmune disorders. During the course of the disease, the body produces antibodies that are directed against an intrinsic factor (IF or Castle's factor), which is produced by the parietal cells in the stomach. By attaching to vitamin B12 in the stomach, this factor allows it to be transported through the intestinal wall and into the blood. However, due to the destruction of the intrinsic factor by antibodies, vitamin B12 cannot be properly absorbed by the body, which leads to its deficiency, and further to disorders of metabolism and nucleic acid synthesis.

CHECK>>How does vitamin B12 deficiency cause anemia?

Other factors leading to vitamin B12 deficiency and, consequently, anemia are:

  • congenital deficiency of internal factor
  • improperly balanced diet
  • anorexia
  • alcoholism
  • condition after gastric (or small intestine) resection
  • Leśniowski and Crohn's disease

Pernicious anemia - symptoms

1. The symptoms of pernicious anemia are very similar to those of iron deficiency anemia:

  • weakness
  • headaches and dizziness
  • pale skin and mucous membranes
  • tachycardia, i.e. increased heart rate

2. Symptoms of the digestive system:

  • glossitis, which often manifests as a burning tongue
  • loss of sense of taste, and hence loss of appetite
  • diarrhea
  • constipation
  • weight loss

3. Neurological symptoms

  • paresthesia, i.e. the sensation of numbness in the limbs
  • unstable gait
  • memory impairment
  • sensory disturbance (this is the result of damage to the posterior spinal cord)
  • weakening of the muscles of the limbs (the result of damage to the lateral cords of the core)
  • optic nerve atrophy

4. Psychiatric symptoms

  • behavioral disorders (e.g. apathy, irritability)
  • disturbance of consciousness
  • depressive states
  • so-called megaloblastic madness, or delusional syndromes resembling schizophrenia

What tests should be performed to diagnose pernicious anemia?

First of all, the level of cobalamin (vitamin B12) in the blood serum is assessed. Below 130 pg / ml indicates its deficiency (the norm is 200-1000 pg / ml). In addition, the presence of specific antibodies in the serum is observed.

In order to diagnose pernicious anemia, a blood count is also performed and a bone marrow biopsy is performed. Addison-Biermer disease is characterized by a low hemoglobin concentration in the blood, the presence of large erythrocytes (MCV over 110 fl).

The content of methylmalonic acid in blood and urine is also checked (its excess indicates a vitamin B12 deficiency).

Antibody testing is performed to rule out intrinsic factor.

When the antibody test is negative, the Schilling test is also performed to assess the absorption of vitamin B12 from the gastrointestinal tract based on its excretion in the urine.

Pernicious anemia - treatment

Under the supervision of an internist or hematologist, take vitamin B12 by intramuscular injection once a day for the first 10-14 days, and then once a month for the rest of your life. Oral medication is possible.

Category:

Cardiology