The Pernicious anemia is hiperhromna, megaloblastic disease, which is caused by the deficit of vitamin B12 and in the breach in the synthesis of nucleic acids. This type of anemia is most common for women of middle and old ages. The Pernicious anemia is autoimmune disease and it frequently combines with other autoimmune diseases. As a result of the autoimmune violations is braking the metabolism of vitamin B12. The patients with pernicious anemia, do not suffer from reduced imports of vitamin B12, but from lack of the intrinsic factor, which is necessary for its absorption. As a result of impaired absorption of vitamin B12 in the terminal ileum is obtained internal B12 deficiency.
In the flow of Pernicious anemia there are two stages – initial period and period of extensive clinical. The symptoms of the first stage are quite simple, as they cannot be perfectly located and often are similar with other diseases, but during the period of extensive clinical the anemia will well determined. Here are the symptoms for both stages:
Initial period of Pernicious anemia symptoms:
• Reduced concentration and General weakness
• Burning pain on the edge of the tongue
• Paresthesias in the limbs
Period of extensive clinical of Pernicious anemia symptoms:
• Haematological syndrome – fatigue, general weakness, breathlessness, headache, pallor and decreased concentration. In some cases the skin has yellow color, due to the combination of pallor with slight jaundice.
• Neurological syndrome – paresthesia of the lower and upper limbs, abnormal gait, abnormal reflexes
• Gastrointestinal syndrome – complaints from atrophic gastritis, anorexia and diarrhea. Often there are trophic changes in mucosal, as here is typical the Hunter glossitis, which has symptoms of red tongue with adjusted papillae, which is burning and has painful hurts. Sometimes there are pharyngitis , stomatitis, ulcers and cracks of the mouth and seriously painful swallowing
All these Pernicious anemia symptoms are serious and well describing the anemia. It is good to know that the Neurological syndrome can even precedes and predicts the anemia. However, if the patient has such complaints, it is necessary to consult with a doctor and get an medical and laboratory tests for diagnosis of the disease.
The diagnosis of the disease is made on the base of clinical and laboratory tests. The most common tests are the peripheral blood images, but also possible tests are the gastroscopy with biopsy and histological examination. The differential diagnosis is done with secondary megaloblastic anemia with iron deficiency anemia, thalassemia and refractory anemia. The accurate and full diagnosis is important for the establishment of the source of the disease and the right treatment. As we know, the Pernicious anemia is not caused by low receive of the Vitamin B12, but to low absorption. So finding the source of the disease will make the above treatment successful.
The treatment of Pernicious anemia is made with vitamin B12 in two stages – active and maintenance treatment. The active treatment is made with injection of vitamin B12 and lasts on average 15-20 days, while the maintenance treatment continues during the whole life.