Pernicious Anemia: Causes, Symptoms, Diagnosis and Treatment

Pernicious anemia is a type of anemia in which there is a reduction in the number of red blood cells. This condition is typically present when there is a lack of B-12 vitamin being absorbed from the GI tract or when the vitamin is not being absorbed appropriately. Commonly referred to as macrocytic achylic anemia, this disorder affects one in 680 individuals or around 400,000 individuals in the United States alone.

Common Causes of Pernicious Anemia

A lack of intrinsic factor is believed to be one of the number one causes of pernicious anemia. Intrinsic factor is needed in the small intestine for the absorption of vitamin B-12. When the stomach does not produce adequate amounts of IF, this interferes not only the amount of B-12 being absorbed but does not allow the small intestine to absorb the vitamin properly. In a significant amount of cases, the vitamin B-12 deficiency is primarily responsible for this condition. Other common causes of pernicious anemia include autoimmune disorders that attack the cells that secrete or are associated with IF. However, in some rare cases this type of anemia may also be inherited.

Symptoms of B-12 Deficiency Related Anemia

Symptoms of pernicious anemia may consist of weight loss, fatigue, diarrhea, confusion, irritability, and muscle weakness. Since the onset of the vitamin B-12 deficiency is not sudden, symptoms may not become apparent for quite some time. Many patients may suffer from the decrease in red blood cells for many months before these symptoms become severe enough to send them to the physician.

Diagnosis

Pernicious anemia is fairly easy to diagnose in many instances. A blood test is the most common diagnostic tool used to detect the disorder. At times, the physician may also order a urine test. Blood tests are used to determine the number of red blood cells and to check the appearance. Anemia resulting from a vitamin B-12 deficiency not only decreased the number of the red blood cells but alters the size and shape of the cells. Other tests used to aid in the diagnosis of pernicious anemia are also typically blood tests and may consist of a methylmalonic acid test, antibodies test, and/or a Schilling test.

Treatment and Prognosis of Pernicious Anemia

Prognosis of this vitamin B-12 deficiency related anemia is very good. Treatments can be used to effectively manage not only the symptoms of the anemia but can successfully treat the cause by eliminating the vitamin B-12 deficiency. The most common treatment methods available for pernicious anemia include changes in diet and B-12 injections and/or intranasal sprays.

Works Cited

Vitamin Deficiency Anemia. MayoClinic. Www.mayoclinic.com 20, March 2009. Viewed 7, December 2009.

Pernicious Anemia. Antony AC. Megaloblastic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 170