Pernicious anemia
Alternative names:
Addison's anemia; Biermer's anemia; macrocytic achylic anemia;
congenital pernicious anemia; juvenile pernicious anemia;
vitamin B12 deficiency (malabsorption)
Treatment:
Monthly Vitamin B12
injections are the definitive treatment for this disorder.
This therapy corrects the anemia and may correct the neurological
complications if given soon enough. Since about 1 percent
of vitamin B12 is absorbed even in the absence of intrinsic
factor, some doctor recommend elderly patients with gastric
atrophy to take oral vitamin B12 supplements in addition to
monthly injections. There is also a preparation of vitamin
B12 that may be given intranasally (in the nose). A well-balanced
diet is essential to provide other components for healthy
blood cell development such as folic
acid, iron, and vitamin
C for healthy blood cell development.
Expectations (prognosis):
The outcome is usually excellent with treatment.
Complications:
- People with pernicious anemia may have gastric polyps
and have twice the incidence
of gastric cancer than
the normal population.
- Persistent neurological defects may be present if treatment
is delayed.
- Vitamin B12 deficiency
affects the appearance of all epithelial
cells, therefore an untreated woman may obtain a false
positive pap smear.
Calling your health care provider:
Call for an appointment with your health care provider if
symptoms of pernicious anemia develop.
References:
1. Toh BH, van Driel IR, Gleeson PA. Pernicious
Anemia. N Engl J Med 1997 Nov 13;337(20):1441-8.
2. Rosenblatt DS, Whitehead VM. Cobalamin
and folate deficiency:acquired and hereditary disorders in
children. Semin Hematol 1999 Jan;36(1):19-34.
3. Markle HV. Cobalamin. Crit Rev Clin Lab
Sci 1996;33(4):247-356.
Updated Date: 06/22/00
Adam S. Levy, MD Chief Fellow, Department
of Pediatrics Memorial Sloan-Kettering Cancer Center , VeriMed
Health Network
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