Pernicious Anemia- Causes, Symptoms and Treatment

Pernicious Anemia

is a condition which is characterized by a significant depletion in the red blood cells in the body. It is caused by the malabsorption of Vitamin B12 in the digestive tract. Vitamin B12 is essential for the formation of the red blood cells. It is essentially a megaloblastic anemia which is indicative of impaired DNA synthesis and affects the red blood cell production.

What is the mechanism behind Pernicious Anemia?

Vitamin B12 is derived from diet in the body. However, the body needs a special protein called Intrinsic Factor to absorb Vitamin B12. Intrinsic Factor is released from the parietal cells in the lining of the gastrointestinal tract. In an autoimmune disease like atrophic gastritis, the immune system behaves weirdly and starts destroying the parietal cells and the intrinsic factor. The gastric lining is also weakened. The resulting loss of the parietal cells and the intrinsic factor makes it impossible for the vitamin B12 to bind with the intrinsic factor and hence affects the absorption and intake of vitamin B12 in the body.

Anything which causes the gastric acid secretion in the body to slow down also causes this anemia.

Tumors, stomach cancer and ulcers may cover up majority of the mucosal lining leaving few parietal cells to release the intrinsic factor.

Other reasons of vitamin B12 deficiency are tape worm infection and the after effect of gastric bypass surgery.


The symptoms may be similar to normal anemia in most cases but the risks associated with the disease are as grave as gastric cancer and carcinoids (tumors in the neuroendocrine system).

The common symptoms of the disease are as follows:

  • Sore tongue, weakness and paresthesias (numbness, tingling, pricking of skin due to affected nerve function).
  • Hypertension, fatigue, pale skin, depression, muscle weakness, loss of balance and rapid heart rate (tachycardia).
  • Mild problems concerning the cognitive abilities of the individual like difficulty in concentration , confusion and depression.
  • Jaundice caused by the malformation of the red blood cells.
  • Glossitis or an inflamed red tongue may be present.

Treatment of Pernicious Anemia

The condition can be reversed by additionally supplementing the body with Vitamin B12. However, this is true only when the nerve damage caused by the vitamin B12 deficiency is not severe. The vitamin B12 supplement is administered by injections or oral pills. In severe cases and sometimes in elderly patients both are done in the same time. Vitamin B12 can also be given nasally.

It is of utmost importance to eat well. A balanced diet can help in the proper intake of the Vitamin B12 which can prevent anemia. Additionally, it is important to eat food which are good sources of folic acid, vitamin C and iron. The supplements of the latter should also be taken along with the above.

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