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Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia. Pernicious anemia is a decrease in red blood cells that occurs when the intestines cannot properly absorb vitamin B12.
The body needs vitamin B12 to make red blood cells. This type of vitamin can be obtained from eating foods such as meat, poultry, shellfish, eggs, and dairy products. A special protein called intrinsic factor(IF) binds vitamin B12 so that it can be absorbed in the intestines. This protein is released by cells in the stomach. Intrinsic factor, the intestine cannot properly absorb vitamin B12. Common causes of pernicious anemia include Weakened stomach lining (atrophic gastritis) An autoimmune condition in which the body’s immune system attacks the actual intrinsic factor protein or the cells in the lining of your stomach that make it.
Signs and Symptoms: Vitamin B12 deficiency may lead to nerve damage. This can cause tingling and numbness in your hands and feet, muscle weakness, and loss of reflexes. The patient also may feel unsteady, lose balance, and have trouble walking. Vitamin B12 deficiency can cause weakened bones and may lead to hip fractures.
Severe vitamin B12 deficiency can cause neurological problems, such as confusion, dementia, depression, and memory loss. Other symptoms of vitamin B12 deficiency involve the digestive tract.
Diagnosis: Doctor will diagnose pernicious anemia based on your medical and family histories, a physical exam, and test results.
The doctor first finds out whether the condition is due to a lack of intrinsic factor or another cause and also the severity of the condition so that it can be treated.
Diagnostic Tests and Procedures: Complete blood count- First test. This test measures many parts of your blood. For this test, a small amount of blood is drawn from a vein (usually in your arm) using a needle. A CBC checks your hemoglobin and hematocrit levels. Hemoglobin is an iron-rich protein that red blood cells carry oxygen from the lungs to the rest of the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low-level of hemoglobin or hematocrit is a sign of anemia.
Other Blood tests- If CBC results confirm that you have anemia, you may need other blood tests to find out what type of anemia you have
A reticulocyte count measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate. People who have pernicious anemia have low reticulocytes. Another common test, called the Combined Binding Luminescence Test, sometimes give false results. Bone marrow tests can show whether your bone marrow is healthy and making enough red blood cells. The two bone marrow tests are aspiration and biopsy. For aspiration, your doctor removes a small amount of fluid bone marrow through a needle. For a biopsy, the doctor removes a small amount of bone marrow tissue through a larger needle. The samples are then examined under a microscope. In pernicious anemia, the bone marrow cells that turn into blood cells are larger than normal.
Treatment: The goals of treating pernicious anemia include:
Preventing or treating the anemia and its signs and symptoms.
Preventing or managing complications, such as heart or nerve damage. Treating the cause of the pernicious anemia
Specific Types of Treatment: Pernicious anemia usually is treated with vitamin B12 shots or pills. In case of a severe case of pernicious anemia, the doctor may recommend shots. Shots are usually given in a muscle every day or every week until the level of vitamin B12 in your blood increases. For less severe cases of pernicious anemia, your doctor may recommend large doses of vitamin B12 pills. A vitamin B12 nose gel and spray also are available. Your signs and symptoms may begin to improve within a few days after your treatment starts.
If your pernicious anemia is caused by something other than a lack of intrinsic factor, you may get treated for the cause (if the cause can be found).
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