Pernicious Anemia

Pernicious Anemia General Information

Pernicious Anemia, also known as Biermer’s Anemia or Addison’s anemia is a type of megaloblastic anemia caused by vitamin B12 deficiency into the patient’s organism, or by the inability to absorb this kind of vitamin due to absence of an intrinsic factor in the patient’s setting of atrophic gastritis. Pernicious Anemia can also be caused by a loss of gastric parietal cells. Generally, the B12 can not be produced by the patient’s body and must be taken from foods. Usually, this kind of vitamin can only be absorbed into the body by the ileum when it is bound by the intrinsic factor secreted by the parietal cells of the gastric mucosa. When the process is impaired due to loss of parietal cells it causes deficient absorption of the vitamin and leads to the appearance of this kind of anemia. In another way of speaking, the anemia is a result of the patient’s inability to produce DNA in enough amounts for blood cells synthesis, because of the interruption of the biochemical pathway that rely on vitamin B12 and on folic acid that work in addition to the vitamin. By combining folic acid with B12 it results an enzyme called thymine which is a DNA component responsible with blood cells synthesis. There are cases in which, in temperate climates, certain factors lead to an impaired binding of B12 by the intrinsic factors and can appear as a condition called autoimmune atrophic gastritis, which consists in auto antibodies that attack the parietal cells and the intrinsic factors causing Pernicious Anemia.

Pernicious Anemia Symptoms

In most cases, the signs and symptoms caused by Pernicious Anemia are similar to those of any other anemia and can appear as pallor, fatigue, shortness of breath, known as sighs, rapid heartbeat, red, burning, and sore tongue, upset stomach, weight loss, loss of appetite, diarrhea, constipation, abdominal pain, jaundice due to impaired formation of blood cells. These are not all the symptoms that can be caused by the presence of this medical disorder. Other patients have complained of fever, malaise, paresthesias which can appear as finger paresthesias, pins and needles, tingling and burning fingers, and numb fingers, muscle tone problems that can appear as muscle spasms, unsteadiness, movement disorders, weakness, spasticity, personality changes, and chest pain. In most cases, the signs and symptoms caused by Pernicious Anemia can be categorized depending on what part of the body is affecting and can include heart: shortness of breath, chest pain, heart murmurs, a rapid heart rate, and heart failure; nerves and brain: in addition to tingling or numbness in the hands and feet, symptoms that appear on nerves and brain include difficulty walking, unsteady movement, loss of balance, changes in vision, taste, and smell, memory loss, confusion, depression, changes in bowel habits that can lead to constipation or diarrhea, loss of appetite and weight loss. It is very important to treat Pernicious Anemia in an early stage to avoid any complications that can threat the life of the patient. For further information, contact your health care provider.

Pernicious Anemia Treatment

In most cases, to diagnose Pernicious Anemia doctors need to perform a demonstration of megaloblastic anemia or a full blood count which helps determine the mean corpuscular volume or MCV and the mean corpuscular hemoglobin concentration or MCHC. If the patient is suffering from this kind of disease he will present a high level of MCV and a normal level of MCHC. These values can easily be mistaken with those of other types of anemia including the macrocytic normochromic anemia which has both levels of MCV and MCHC high. Another way to determine if the patient is suffering from Pernicious Anemia is to observe if the ovalocytes are seen on the blood smear and to examine the pathognomonic feature of megaloblastic anemia which consists in hypersegmented neutrophils. Another way to diagnose the disease is to evaluate the direct cause of it, the level of B12 vitamin in serum.

There are doctors who perform a Schilling test that can help him to distinguish this kind of anemia from other causes of vitamin B12 deficiency. Some doctors try to diagnose atrophic gastritis which can be confirmed by performing gastroscopy with biopsies. In most cases patient who suffer from Pernicious Anemia have antibodies for the parietal cells. Usually, the first option in treating the disease is to replace the missing B12 vitamin into the patient’s body, and most patients have to take the treatment for the rest of their lives. The main goals of any treatment for this kind of disease can include stopping the anemia and relieving the symptoms caused by vitamin B12 deficiency, preventing complications such as heart and nerve damage, providing ongoing follow up assure that the treatment is effective, and treating the main cause of the disease, in cases in which it can be precisely determined. There are some specific treatment options for Pernicious Anemia, but all consist in replacing the missing vitamin B12 in the patient’s body. In most cases, signs and symptoms start to improve in the first days after applying the treatment.

The treatment therapy consists in Vitamin B12 supplements that can be administered weekly and after a while, monthly, and can be taken in certain forms such as pills and shots. In most cases the shot form is more effective due to the fact that is absorbed rapidly and fully of the amount given, but to achieve the same effect, large doses of pills are administrated. There are cases in which the doctor chooses to give the medicine in gel or spray for the nose. Usually, when a patient also presents stomach infections, doctors prescribe, in combination with the Vitamin B12 supplements, a treatment trial with antibiotics to cure the infection and maximize the effects. There are cases in which the vitamin B12 deficiency is caused by a poor diet, and then doctors will prescribe a correct diet. The optimal diet to improve Pernicious Anemia consists in eggs, meat, poultry, shellfish, milk, orange juice, oranges, cereals, wheat germ, rice, barley, spinach, sprouts, broccoli, peanuts, beans, lentils and chickpeas.