Find information on thousands of medical conditions and prescription drugs.

Anemia, Pernicious

Pernicious anemia refers to a type of autoimmune anemia. Antibodies are directed against intrinsic factor or parietal cells which produce intrinsic factor. Intrinsic factor is required for vitamin B12 absorption, so impaired absorption of vitamin B12 can result. more...

Home
Diseases
A
Aagenaes syndrome
Aarskog Ose Pande syndrome
Aarskog syndrome
Aase Smith syndrome
Aase syndrome
ABCD syndrome
Abdallat Davis Farrage...
Abdominal aortic aneurysm
Abdominal cystic...
Abdominal defects
Ablutophobia
Absence of Gluteal muscle
Acalvaria
Acanthocheilonemiasis
Acanthocytosis
Acarophobia
Acatalasemia
Accessory pancreas
Achalasia
Achard syndrome
Achard-Thiers syndrome
Acheiropodia
Achondrogenesis
Achondrogenesis type 1A
Achondrogenesis type 1B
Achondroplasia
Achondroplastic dwarfism
Achromatopsia
Acid maltase deficiency
Ackerman syndrome
Acne
Acne rosacea
Acoustic neuroma
Acquired ichthyosis
Acquired syphilis
Acrofacial dysostosis,...
Acromegaly
Acrophobia
Acrospiroma
Actinomycosis
Activated protein C...
Acute febrile...
Acute intermittent porphyria
Acute lymphoblastic leukemia
Acute lymphocytic leukemia
Acute mountain sickness
Acute myelocytic leukemia
Acute myelogenous leukemia
Acute necrotizing...
Acute promyelocytic leukemia
Acute renal failure
Acute respiratory...
Acute tubular necrosis
Adams Nance syndrome
Adams-Oliver syndrome
Addison's disease
Adducted thumb syndrome...
Adenoid cystic carcinoma
Adenoma
Adenomyosis
Adenosine deaminase...
Adenosine monophosphate...
Adie syndrome
Adrenal incidentaloma
Adrenal insufficiency
Adrenocortical carcinoma
Adrenogenital syndrome
Adrenoleukodystrophy
Aerophobia
Agoraphobia
Agrizoophobia
Agyrophobia
Aicardi syndrome
Aichmophobia
AIDS
AIDS Dementia Complex
Ainhum
Albinism
Albright's hereditary...
Albuminurophobia
Alcaptonuria
Alcohol fetopathy
Alcoholic hepatitis
Alcoholic liver cirrhosis
Alektorophobia
Alexander disease
Alien hand syndrome
Alkaptonuria
Alliumphobia
Alopecia
Alopecia areata
Alopecia totalis
Alopecia universalis
Alpers disease
Alpha 1-antitrypsin...
Alpha-mannosidosis
Alport syndrome
Alternating hemiplegia
Alzheimer's disease
Amaurosis
Amblyopia
Ambras syndrome
Amelogenesis imperfecta
Amenorrhea
American trypanosomiasis
Amoebiasis
Amyloidosis
Amyotrophic lateral...
Anaphylaxis
Androgen insensitivity...
Anemia
Anemia, Diamond-Blackfan
Anemia, Pernicious
Anemia, Sideroblastic
Anemophobia
Anencephaly
Aneurysm
Aneurysm
Aneurysm of sinus of...
Angelman syndrome
Anguillulosis
Aniridia
Anisakiasis
Ankylosing spondylitis
Ankylostomiasis
Annular pancreas
Anorchidism
Anorexia nervosa
Anosmia
Anotia
Anthophobia
Anthrax disease
Antiphospholipid syndrome
Antisocial personality...
Antithrombin deficiency,...
Anton's syndrome
Aortic aneurysm
Aortic coarctation
Aortic dissection
Aortic valve stenosis
Apert syndrome
Aphthous stomatitis
Apiphobia
Aplastic anemia
Appendicitis
Apraxia
Arachnoiditis
Argininosuccinate...
Argininosuccinic aciduria
Argyria
Arnold-Chiari malformation
Arrhythmogenic right...
Arteriovenous malformation
Arteritis
Arthritis
Arthritis, Juvenile
Arthrogryposis
Arthrogryposis multiplex...
Asbestosis
Ascariasis
Aseptic meningitis
Asherman's syndrome
Aspartylglycosaminuria
Aspergillosis
Asphyxia neonatorum
Asthenia
Asthenia
Asthenophobia
Asthma
Astrocytoma
Ataxia telangiectasia
Atelectasis
Atelosteogenesis, type II
Atherosclerosis
Athetosis
Atopic Dermatitis
Atrial septal defect
Atrioventricular septal...
Atrophy
Attention Deficit...
Autoimmune hepatitis
Autoimmune...
Automysophobia
Autonomic dysfunction
Familial Alzheimer disease
Senescence
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Medicines

The term pernicious anemia is sometimes used more loosely to include non-autoimmune causes of vitamin B12 deficiency.

Diagnosis

Blood testing typically shows a macrocytic anemia, and low levels of serum vitamin B12. A Schilling test can then be used to distinguish between pernicious anemia, vitamin B12 malabsorption, and vitamin B12 deficiency. Approximately 90% of individuals with pernicious anemia have antibodies for parietal cells, however only 50% of individuals with these antibodies have the disease.

History

The treatment for pernicious anemia was first devised by William Murphy who bled dogs to make them anemic and then fed them various substances to see what (if anything) would make them healthy again. He discovered that ingesting large amounts of liver seemed to cure the disease. George Minot and George Whipple then set about to chemically isolate the curative substance and ultimately were able to isolate the vitamin B12 from the liver. For this, all three shared the 1934 Nobel Prize in Medicine. As a result, pernicious anemia is now treated with either vitamin B12 injections (hydroxocobalamin or cyanocobalamin), or large oral doses of vitamin B12, typically between 2 and 4 mg daily.

Maurice Beddow Bayly, an anti-vaccinationist and anti-vivisectionist, campaigned against the use of liver therapy, having failed to recognise the nature of the disease (despite reciting the necessary information) .

Symptoms

Pernicious anemia may cause inflammation of the tongue (glossitis). It is also associated with premature greying, blue eyes, vitiligo, and blood group A.

Treatment

Treatment is with vitamin B12 (hydroxycobalamin or cyanocobalamin) injected intramuscularly. Body stores (in the liver) are refilled with half a dozen injections in the first couple of weeks and then maintenance with monthly to quarterly injections throughout the life of the patient.

B12 has traditionaly been given parenterally to ensure absorption. Alternatively, since it has become appreciated that when B12 given orally in sufficient quantity is absorbed regardless of intrinsic factor or the ileum, oral replacement has emerged as an accepted route. Generally 1000 to 2000 mcg daily is required . By contrast, the typical Western diet contains 5-7 mcg of B12.

Read more at Wikipedia.org


[List your site here Free!]


Folic acid, pernicious anemia, and prevention of neural tube defects
From Nutrition Research Newsletter, 2/1/94

Both the United Kingdom and the United States have planned programs of folic acid fortification of staple foods in an effort to ensure that women of childbearing age receive enough of this vitamin to minimize the occurrence of neural tube defects. Concerns have been expressed, however, about the possibility that individuals with vitamin [B.sub.12] deficiency might consume enough of the fortified foods to mask the anemia associated with this deficiency, leading to delayed diagnosis and the possibility of permanent neurologic damage.

In a commentary published in The Lancet, Nicholas J Wald and Carol Bower of the Wolfson Institute of Preventive Medicine at St Bartholomew's Hospital, London, contend that this concern is misplaced. They state, "We believe that it is a mistake to regard this effect--the correction of the blood abnormality in pernicious anaemia by folic acid--as a masking of the disease or as a toxic effect of the vitamin. Currently about 12% of patients with pernicious anaemia present with neuropathy alone. An increase in dietary folic acid might increase this percentage while reducing the proportion of patients presenting with anaemia....It is not necessary to 'preserve' the anaemia to achieve an earlier diagnosis. Moreover, it is unreasonable to encourage extra haematological morbidity to help make the diagnosis, which in any case should be based on assessment of [B.sub.12] status."

Concerns about the possibility of masking the anemia of vitamin [B.sub.12] deficiency have prompted authorities to recommend relatively low levels of folic acid fortification--levels which may not be adequate to provide all women of childbearing potential with sufficient folic acid. The authors criticize this decision, stating, "Concern over the presence or absence of an accompanying macrocytosis or anaemia [in patients with neurologic symptoms attributable to vitamin [B.sub.12] deficiency] is misplaced; and, to the extent that this might limit public health measures designed to prevent neural tube defects, it represents an error of judgment. The haematological effect of folic acid in pernicious anaemia should not be used as a reason for failure to implement adequate folic acid fortification for prevention of neural tube defects." Nicholas J Wald and Carol Bower, Folic Acid, Pernicious Anaemia, and Prevention of Neural Tube Defects [Commentary], Lancet 343(8893):307 (5 Feb 1994)

COPYRIGHT 1994 Frost & Sullivan
COPYRIGHT 2004 Gale Group

Return to Anemia, Pernicious
Home Contact Resources Exchange Links ebay