What Is Pernicious Anemia?

Pernicious anemia, a potentially fatal nutritional deficiency, is easily treated by regular intramuscular injections of vitamin B-12.

Pernicious anemia is a potentially fatal nutritional deficiency cause by the body's inability to absorb vitamin B-12, which is essential to the body's production of red blood cells. Pernicious anemia is caused by the absence of intrinsic factor, a substance secreted by the stomach. Intrinsic factor facilitates the absorption of vitamin B-12. A blood test can confirm a diagnosis of pernicious anemia, by revealing the presence of megaloblasts in the blood. A megaloblast is a large erythroblast, and an erythroblast is the first identifiable stage in the development of a red blood cell. In pernicious anemia, the number of red blood cells decreases, but their size and hemoglobin content increases.

Because the body stores B-12 very efficiently, it takes years for pernicious anemia to develop and for symptoms to begin to show.

What are the symptoms of pernicious anemia?

A tingling numbness in the feet and hands ("boot and glove" numbness) is a common symptom of pernicious anemia. It occurs because of nerve damage caused by the B-12 deficiency.

Another frequent symptom is memory loss--not a momentary forgetfulness, but actual "erasures" or "holes" in the memory. Left untreated, this symptom can develop into a secondary dementia, which resembles such primary dementias as Alzheimer's disease. Unlike primary dementias, however, secondary dementias can be treated and usually reversed if proper diagnosis of the cause of the dementia leads to appropriate treatment.

Like other anemias, pernicious anemia is associated with fatigue and a lack of energy, but in the absence of other characteristic symptoms, fatigue alone is unlikely to suggest a diagnosis of pernicious anemia.

Similarly, other symptoms associated with pernicious anemia may also suggest other conditions, unless accompanied by symptoms more obviously characteristic of pernicious anemia, or unless pernicious anemia has already been diagnosed by means of a blood test. Such symptoms may include weakness, loss of appetite, unexplained weight loss, pallor (paleness) or jaundice (yellowish skin tone), a red or inflamed tongue, gastrointestinal distress, and nervous disturbancs.

Can pernicious anemia be cured?

There is no cure for pernicious anemia, but it can be successfully treated with intramuscular injections of vitamin B-12, usually administered at three- to four-week intervals. Left untreated, pernicious anemia will cause progressive and eventually permanent nerve damage, memory loss (potentially leading to fully developed dementia), and ultimately death. With timely diagnosis and treatment, however, existing nerve damage can be partially or completely reversed, as can the secondary dementia caused by the disease.

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