Pernicious anemia

Alternative Names

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

Symptoms

Too little vitamin B12 gradually causes neurological problems. It is important to know that the neurological effects may be seen before anemia is diagnosed.

Symptoms may include:

• Shortness of breath
• Fatigue
• Pallor
• Rapid heart rate
• Loss of appetite
• Diarrhea
• Tingling and numbness of hands and feet
• Sore mouth
• Unsteady gait, especially in the dark
• Tongue problems
• Impaired sense of smell
• Bleeding gums
• Positive Babinski's reflex
• Loss of deep tendon reflexes
• Personality changes, "megaloblastic madness"

Exams and Tests

Tests that may used to diagnose or monitor pernicious anemia include:

• Complete blood count
• Bone marrow examination (only needed if diagnosis is unclear)
• Measurement of serum holotranscobalamin II
• Measurement of methylmalonic acid (MMA)
• Reticulocyte count
• Serum LDH
• Schilling test
• Vitamin B12 level

This disease may also alter the results of the following tests:

• Bilirubin
• Cholesterol test
• Gastrin
• Leukocyte alkaline phosphatase
• Peripheral smear
• TIBC

Vitamin B12 deficiency affects the appearance of all epithelial cells, therefore an untreated woman may have a false positive pap smear.