Pernicious anaemia

Question 1

What is pernicious anaemia?

Answer 1

An autoimmune disorder affecting the gastric mucosa that results in vitamin B12 deficiency

Question 2

What is the pathophysiology of pernicious anaemia?

Answer 2

Antibodies form to intrinsic factor and/or gastric parietal cells

This reduces the absorption of vitamin B12

Question 3

What are the features of pernicious anaemia?

Answer 3

Lethargy
Pallor
Dyspnoea
Peripheral neuropathy
Subacute combined degeneration of the cord

Question 4

What investigations are used in the diagnosis of pernicious anaemia?

Answer 4

FBC
Vitamin B12 and folate levels
Antibodies
- Anti intrinsic factor antibodies
- Anti gastric parietal cell antibodies

Question 5

Which antibodies are the most specific to pernicious anaemia?

Answer 5

Anti intrinsic factor antibodies

Question 6

What is the first line management of pernicious anaemia?

Answer 6

IM hydroxocobalamin

Question 7

How often is treatment given in pernicious anaemia?

Answer 7

IM vitamin B12 given 3 times per week for two weeks, followed by 3 monthly injections