Pernicious anaemia

Question 1

Pernicious anaemia - Epidemiology?

Answer 1

• more common in females (F:M = 1.6:1)
• typically develops in middle to old age
• more common if blood group A

Question 2

Pathophysiology?

Answer 2

• autoimmune disease caused by antibodies to gastric parietal cells or intrinsic factor
• results in vitamin B12 deficiency
• associated with thyroid disease, diabetes, Addison’s, rheumatoid and vitiligo
• predisposes to gastric carcinoma

Question 3

Features?

Answer 3

• lethargy, weakness
• dyspnoea
• paraesthesia
• also: mild jaundice, diarrhoea, sore tongue
• possible signs: retinal haemorrhages, mild splenomegaly, retrobulbar neuritis

1. Treatment of the disorder is with 3 monthly treatment of vitamin B12 injections.
2. Folic acid supplementation may also be required.