Pernicious anemia is a megaloblastic anemia caused by the inability to absorb vitamin B12. It can be diagnosed before anemia occurs and is treatable with B12 supplementation. It is more common in people of Northern European and African ancestry, older adults, and those with a family history or underlying conditions.
Pernicious anemia is a form of megaloblastic anemia caused by an inability to properly absorb vitamin B12. Megaloblastic anemias involve red blood cells, and in the case of pernicious anemia, the red blood cells are depleted and may be malformed. Historically, this condition wasn’t identified until people already experienced symptoms of anemia, including complications, but today it can be diagnosed with screening before anemia occurs. People with a family history of pernicious anemia should consider screening to see whether or not they are at risk.
There are a number of potential causes of pernicious anemia. One is a congenital form, in which a child is born without the ability to absorb vitamin B12. In other cases, an underlying disease process interferes with the absorption of this vitamin. In patients with pernicious anemia, the stomach does not make enough of a substance called intrinsic factor. Without an intrinsic factor, the intestines cannot absorb vitamin B12, which is passed as a waste product, rather than being absorbed. Once the body has depleted its stores of vitamin B12 in red blood cell production, anemia begins to emerge.
Patients with this condition often experience gastrointestinal problems in addition to the classic symptoms of anemia such as weakness, lethargy, and pale skin. Pernicious anemia can be diagnosed with a blood test and a test in which vitamin B12 is injected and a test is done to see how much has been absorbed. Although this condition was once dangerous because it was identified late in many cases, today it is very treatable.
Treatment for pernicious anemia is B12 supplementation, to make sure the body gets enough of this vitamin. One of the best ways to do this is with periodic injections of vitamin B12 directly into the muscle. If injections are not an option, a patient may be given B12 pills to take. If symptoms aren’t resolved, further tests may be done to see if supplementation doses need to be changed and to check for other problems that could be causing anemia.
Also known as Addison-Biermer anemia, pernicious anemia tends to be more common in people of Northern European and African ancestry. Individuals at risk include older adults with these genetic backgrounds, people with a family history of the disease, and people with conditions such as diabetes. People who have had bowel resection or gastric bypass surgery are also at risk for pernicious anemia, in addition to deficiencies caused by an inability to absorb nutrients properly.
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