Pernicious anemia - Vitamin B12 deficiency disease

Other Names: Macrocytic achylic anemia; Congenital pernicious anemia; Juvenile pernicious anemia; Vitamin B12 deficiency (malabsorption)

Pernicious anemia is a chronic illness caused by impaired absorption of vitamin B-12 because of a lack of intrinsic factor (IF) in gastric secretions. The disease was named pernicious anemia because it was fatal before treatment became available, first as liver therapy and, subsequently, as purified vitamin B-12. The term pernicious is no longer appropriate, but it is retained for historical reasons.

Vitamin B12, in turn, is necessary for the formation of red blood cells. Anemia is a condition where red blood cells are not providing adequate oxygen to body tissues.

Causes of Pernicious anemia

Megaloblastic (pernicious) anemia is more common in individuals of northern European descent. Megaloblastic (pernicious) anemia results from a lack of intrinsic factor in gastric secretions (a substance needed to absorb vitamin B12 from the gastrointestinal tract). Vitamin B12 deficiency results.

Symptoms of Pernicious anemia

  • Nausea or poor appetite
  • Weight loss
  • Diarrhea
  • Weakness and fatigue
  • Light-headedness and dizziness
  • A sore tongue that has a red, beefy appearance
  • Yellowish tinge to the skin and eyes
  • Palpitations and rapid heartbeat
  • Shortness of breath

Treatment of Pernicious anemia

Treatment includes iron replacement for life and administration of vitamin B 12 injections. Since about 1% of vitamin B12 is absorbed (even in the absence of intrinsic factor), some doctors recommend that elderly patients with gastric atrophy take oral vitamin B12 supplements in addition to monthly injections.


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