Pernicious anemia


Pernicious anemia

Symptoms that characterize pernicious anemia:

  • Anemic syndrome: increased weakness and fatigue, lack of ability to perform previous workloads. The patient rises to a temperature of 37-37.5 degrees, dizziness often occurs, fainting may occur. The shortness of breath increases, it arises even in a state of rest. There is a noise in the ears, before the eyes can periodically “fly flies.” Skin covers acquire unnatural pallor, can give some yellow. The face swells slightly. When listening to heart sounds, you can detect systolic noises. If anemia progresses, then this is associated with a risk of myocardial dystrophy and heart failure.

  • Gastroenterological syndrome is nausea, constipation, vomiting, lack of desire to eat, weight loss. The patient’s tongue becomes inflamed, starts to ache, becomes bright crimson, its surface shines, as if polished (Hunter’s glossitis). In the corners of the mouth formed “jam”. If you perform FGDS, then you can detect atrophy of the gastric mucosa.

  • Neurological syndrome: muscle weakness, gait change, numbness of limbs. Seizures and lack of sensitivity are observed when the spinal cord and brain are affected. Tendon reflexes are amplified, Romberg’s symptom and Babinsky’s reflex become positive. The signs characteristic of funicular myelosis develop.

In addition, a person becomes nervous, all the time is in apathy. Also affects the genitourinary system with the development of impotence and urinary incontinence. In severe cases, hallucinations may occur, color perception may deteriorate (yellow and blue).

How to detect pernicious anemia?

Basic diagnostic measures:

  • Interrogation of patient, collection of anamnesis, including, study of the family history of the disease.

  • Physical examination with assessment of the skin, listening to the pulse, measuring blood pressure and examining the oral cavity to detect glossitis.

  • Purpose of laboratory tests. The methods of laboratory diagnostics are:

    • Blood sampling for a general analysis.

    In case of anemia, a decrease in the level of erythrocytes, their increase in size, a decrease in the number of reticulocytes, hemoglobin, platelets will be found (platelets become larger in diameter). Data of the color index of blood with pernicious anemia exceed values ​​of 1.05, at a rate of 0.86-1.05.

  • Urine collection for analysis, which provides information on concomitant diseases. Also, this study provides some information on hereditary forms of pernicious anemia.

  • Blood sampling for biochemical analysis. Anemia will be indicated by a decrease in the level of vitamin B12, an increase in the level of bilirubin (the product of the decay of erythrocytes) and iron (it remains unclaimed). We can also note an increase in the level of the enzyme called lactate dehydrogenase, which is responsible for accelerating chemical reactions in the body.

In some cases, to refine the diagnosis, perform a bone marrow puncture. Pernicious anemia will be indicated by the megaloblastic type of hematopoiesis and rapid production of red blood cells.

To auxiliary diagnostic methods are:

  • ECG. This study provides information on heart rate and heart rate disorders.

  • FGDS. Inspection of the intestinal mucosa and stomach with an endoscope can detect pathological changes on them.

  • X-ray of the stomach, ultrasound examination of internal organs.

  • Neurological examination, passage of MRI.

The Shilling test allows you to determine whether vitamin B12 is absorbed into the body. For this, the patient is offered to drink a radioactive solution of vitamin B12, and after a while he is offered an impressive dose of normal vitamin B12. After that, the urine is collected for analysis and counts how much of the labeled vitamin was excreted by the body in a day. If little is deduced by its or his kidneys, it means in an intestine he sucks in insufficient quantity.

Treatment of pernicious anemia

Therapy of the disease should be based on the causes that triggered its development.

The following drugs can be used for treatment:

  • Vitamin B12 for replenishing its deficiency in the body. Subcutaneously, the drug is administered once a day at a dosage of 200-500 μg. The course lasts 1-1.5 months. Then for 3 months the drug is administered 1 time in 7 days. Then, for another 6 months, it is administered at the prescribed dosage of 2 time in 30 days. Expect results can be 2 months after the start of treatment, although this largely depends on the individual characteristics of the body.

  • Praziquantel for getting rid of parasitic infection.

  • Glucocorticosteroids for the suppression of an autoimmune reaction.

  • Pathogenetic treatment of diseases of the digestive system.

It is necessary to appoint a therapeutic diet to the patient with the inclusion of sour-milk products, red meat, liver, eggs and seafood in the menu.

In severe anemia, a transfusion of erythrocyte mass is possible.

Preventive measures

Prevention measures of pernicious anemia:

  • The human diet should be balanced.

  • All diseases that contribute to the development of anemia must be treated promptly.

  • If a person underwent a resection of the stomach or intestine, then he needs to take vitamin B12 for life in a maintenance dosage for life.


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