Pernicious anemia

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Megaloblastic anemia - view of red blood cells

Macrocytic achylic anemia; Congenital pernicious anemia; Juvenile pernicious anemia; Vitamin B-12 deficiency (malabsorption)

Monthly vitamin B-12 injections are the definitive treatment to correct the vitamin B-12 deficiency. This therapy corrects the anemia and may correct the neurological complications if given soon enough.

Since about 1% of vitamin B-12 is absorbed (even in the absence of intrinsic factor), some doctors recommend that elderly patients with gastric atrophy take oral vitamin B-12 supplements in addition to monthly injections.

There is also a preparation of vitamin B-12 that may be given intranasally (in the nose). A well-balanced diet is essential to provide other elements such as folic acid, iron, and vitamin C for healthy blood cell development.

The outcome is usually excellent with treatment.

• People with pernicious anemia may have gastric polyps and get gastric cancer and gastric carcinoid tumors twice as often than the normal population.
• Persistent neurological defects may be present if treatment is delayed.
• Vitamin B-12 deficiency affects the appearance of all epithelial cells, therefore an untreated woman may obtain a false positive pap smear.

Call your health care provider if symptoms suggestive of vitamin B-12 deficiency develop.

Review Date: 10/31/2005
Reviewed By: William Matsui, MD, Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network.