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| 2712790641 | Aetiology | Absence of intrinsic factor which leads to B12 deficiency | 0 | |
| 2712790993 | Type | Systemic disease, chronic | 1 | |
| 2712791129 | Risk Factors | Infections of surgery that inhibit absorption of B12. Vegetarian/Vegan diet. Bad Bacteria. Diseases such as celiac, crohn's etc. Surgical removal of part/all small intestine. Autoimmune disease. | 2 | |
| 2712802156 | Pathogenesis | Insufficient intrinsic factor, decreased absorption of Vitamin B12, ,affects normal RBC development, creating macrocytic (large cells, RBCs), these defective cells die early, insufficient numbers of erythrocytes, causing hypoxaemia - tissue hypoxia. Pernicious anemia is a normochromic form of anaemia meaning the concentration of haemoglobin in RBCs in normal but there are insufficient numbers of RBCs. | 3 | |
| 2712803762 | Clinical Manifestations | Early symptoms are nonspecific and vague: infections, mood swings, and gastrointestinal, cardiac or kidney ailments. When haemoglobin has decreased to 70-80g/L: weakness, fatigue, paresthesias of feet and fingers, difficulty walking, loss of appetite, abdominal pain, weight loss, sore, smooth, beefy red tongue. Skin may become lemon yellow (combo of pale and jaundice). Neurological abnormalities such as numbness, weakness, and unsteady gait. | 4 | |
| 2712805559 | Red Flags | Abdominal Pain, Weight Loss | 5 | |
| 2712806223 | Diagnostic Approaches | Evaluation is based on blood tests, bone marrow aspiration (draw out), serological studies, gastric biopsy, clinical manifestations and the Schilling Test. Serological studies reveal presence of antibodies against gastric cells and gastric biopsy reveals achlorhydria. | 6 | |
| 2712807316 | Associated Complications | Untreated pernicious anaemia is fatal, usually because of heart failure. Also can cause progressive damage to the nervous system (esp nerves outside brain and spinal cord). Other complications are same as iron def. anaemia. | 7 | |
| 2712808283 | Prognosis | With replacement therapy of Vitamin B12, mortality has decreased significantly. | 8 | |
| 2712808489 | Medical Treatment | Initial replacement therapy of Vitamin B12 is by weekly injections until deficiency is corrected. Monthly injections for the remainder of their life, recent practice is showing oral administration of high dose Vitamin B12 beneficial. | 9 |
