Pernicious Anemia

Posted September 10, 2022 by Anusha ‐ 2 min read

Pernicious anemia, one of the causes of vitamin B12 deficiency, is an autoimmune condition that prevents your body from absorbing vitamin B12. Without adequate vitamin B12, you have fewer red blood cells carrying oxygen throughout your body.

Causes of Pernicious Anemia

  • Pernicious anemia is an autoimmune condition that happens when your immune system produces antibodies that attack cells in the mucosal lining of your stomach and nerve cells.

  • Your immune system’s response affects your body’s ability to absorb vitamin B12.

  • The antibodies also block a critical protein called intrinsic factor.

  • Normally, intrinsic factor carries the vitamin B12 we get from food to special cells in your small intestine.

  • From there, the vitamin B12 is transported into your bloodstream.

  • Other proteins then carry the vitamin B12 to your bone marrow, where the vitamin is used to make new red blood cells.

  • This process can’t happen when your immune system blocks your intrinsic factor.

Symptoms of Pernicious Anemia

  • Diarrhea or constipation.

  • Lightheadedness when standing up or with exertion.

  • Loss of appetite.

  • Pale skin (mild jaundice or yellowing of your eyes or skin).

  • Shortness of breath (dyspnea), mostly during exercise.

  • Heartburn.

  • Swollen, red tongue or bleeding gums.

Diagnosis of Pernicious Anemia

Complete blood count (CBC)

This blood test determines the type of anemia you have and the degree of your anemia.

Reticulocyte count

This test indicates if your bone marrow can make new red blood cells.

Lactate dehydrogenase (LDH) levels

LDH is an enzyme that many cells make. Extremely high LDH levels may indicate pernicious anemia.

Methylmalonic acid (MMA) levels

High MMA levels confirm vitamin B12 deficiency.

Homocysteine level

High homocysteine levels may be a sign of vitamin B12 deficiency. Tests for the presence of the antibodies that attack the parietal cells in your stomach and block the action of intrinsic factor.

Upper endoscopy

Healthcare providers use a thin, tube-like instrument with a light and lens for viewing called an endoscope to look for signs of degeneration or atrophy (wasting away) of the lining of your stomach.

Treatment of Pernicious Anemia

  • Since vitamin B12 absorption is blocked, your healthcare provider may prescribe intramuscular vitamin B12 injections.

  • Later, after B12 stores are back to normal, they may prescribe high doses of oral B12 replacement.

  • They’ll monitor your treatment.

  • They may prescribe antibiotics if you have bacteria in your intestine that prevents your body from absorbing vitamin B12.

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