Pernicious Anaemia

Question 1

what is pericious anaemia?

Answer 1

autoimmune condition which targets the parietal cells (found in the stomach) that produce intrinsic factor

Question 2

what is the intrinsic factor responsible for?

Answer 2

absorption of vitamin B12 in the terminal ileum

Question 3

what are the causes of B12 deficiency?

Answer 3

• gastric causes - pernicious anaemia, chronic severe atrophic gastritis
• pancreatic - any cause of pancreatic insufficiency
• small bowel bacterial overgrowth, terminal ileal resection, severe terminal ileal diseases (e.g. crohns)
• tuberculosis
• metformin therapy
• zollinger-ellison syndrome

Question 4

what are the haematological features of pernicious anaemia?

Answer 4

• low Hb
• high MCV
• high MCH
• normal MCHC
• abnormally large and oval-shaped RBCs
• low B12
• low reticulocyte count
• antibodies against intrinsic factor and/or parietal cell