Symptoms and Diagnosis of Pernicious Anemia

Pernicious Anemia was first described in 1855 by English physician Thomas Addison. The disorder received its name in 1872 by German physician Anton Biermer. Pernicious means highly injurious, destructive or deadly. Although Pernicious Anemia used to have a high death rate, that is no longer the case.

Pernicious Anemia, a type of megaloblastic anemia, occurs when the body cannot absorb Vitamin B-12 and there is a decrease in red blood cells because the body does not produce a protein called intrinsic factor. Intrinsic factor is a protein in the stomach that allows the body to absorb Vitamin B-12, which is needed to form red blood cells.

OTHER NAMES

Pernicious Anemia is also known as macrocytic achylic anemia, congenital pernicious anemia, juvenile pernicious anemia, vitamin B-12 deficiency, Addison anemia, addisonian anemia and Biermer anemia.

SYMPTOMS

Symptoms of Pernicious Anemia usually develop slowly over time and include fatigue, weakness, bright red, smooth tongue, pale yellowish skin, low grade fever and dizziness upon standing. Neurological symptoms include numbness or tingling, depression, memory loss, irritability, loss of balance, confusion, dementia, spasticity, incontinence and erectile dysfunction. Symptoms in infants include unusual movements and failure to thrive. Mental changes and nerve problems may occur before anemia is even diagnosed.

RISK FACTORS

Risk factors for developing Pernicious Anemia include a family history of the disorder, Scandinavian or North European descent, history of autoimmune endocrine disorders, not eating meat and dairy products, having an intestinal disease and a lack of the intrinsic factor.

DIAGNOSIS

Primary Care Physicians can diagnose and treat the disorder, but other specialists such as neurologists, cardiologists, hematologists and gastroenterologists may also be needed.

There are several tests used to diagnose Pernicious Anemia. A Complete Blood Count or CBC is done to check the hemoglobin level and the hematocrit level, the number of red blood cells, the number of white blood cells, the number of platelets in the blood and the red blood cell size. A test is done to check Vitamin B-12 level and other tests are done to check the presence of the intrinsic factor, parietal antibodies, levels of bilirubin, potassium and cholesterol, serum iron and the number of reticulocytes. The Schilling Test and Bone Marrow tests may also be performed.

TREATMENT

Pernicious Anemia is most often treated with injections of Vitamin B-12. Other medications that may be used include injections of cyanocobalamin, cobal, cyanoject, cyomin, vibal, cyanocobalamin given through the nasal passages and nascobal.

DISEASE ASSOCIATION

Pernicious Anemia can be associated with Type 1 Diabetes, hypoarathyroidism, Addison's disease, hypopituitarism, testicular dysfunction, Graves's disease, chronic thyroiditis, Myasthenia Gravis, Secondonary amenorrhea and vitiligo.