Pernicious anemia

Alternative names:

Addison's anemia; Biermer's anemia; macrocytic achylic anemia; congenital pernicious anemia; juvenile pernicious anemia; vitamin B12 deficiency (malabsorption)

Symptoms:

• shortness of breath
• fatigue
• pallor
• rapid heart rate
• loss of appetite
• diarrhea
• tingling and numbness of hands and feet (paresthesias)
• sore mouth
• unsteady gait, especially in the dark
• slowing of mental processes
• tongue problems
• smell, impaired
• gums, bleeding
• positive Babinski's reflex
• loss of deep tendon reflexes
• personality changes ("megaloblastic madness")

Signs and tests:

Tests that may indicate pernicious anemia include:

• CBC results that show low hematocrit and hemoglobin with elevated MCV
• CBC showing low white blood count and low platelets
• low reticulocyte count
• bone marrow examination
• serum LDH
• below normal serum vitamin B-12 level
• Schilling test
• measurement of serum holotranscobalamin II

This disease may also alter the results of the following tests:

• TIBC
• peripheral smear
• leukocyte alkaline phosphatase
• gastrin
• cholesterol test
• bilirubin

Updated Date: 06/22/00

Adam S. Levy, MD Chief Fellow, Department of Pediatrics Memorial Sloan-Kettering Cancer Center , VeriMed Health Network