Question

Mr. Alvis, age 57, presented to his physician with marked fatigue, nausea with occasional diarrhea, and a sore, swollen tongue. Lately he also has been experiencing a tingling feeling in his toes and a feeling of clumsiness. Microscopic examination of a blood sample indicated a reduced number of erythrocytes, many of which are megaloblasts, and a reduced number of leukocytes, including many large, hypersegmented cells. Hemoglobin and serum levels of vitamin B12 were below normal. Additional tests confirm pernicious anemia.

Relate the pathophysiology of pernicious anemia to the manifestations listed above.

Discuss how the gastric abnormalities contribute to vitamin B12 and iron deficiency and how vitamin B12 deficiency causes complications associated with pernicious anemia.

Discuss other tests that could be performed to diagnose this type of anemia.

Answer 1

1.Most common cause of pernicious anaemia is loss of stomach cells that make intrinsic factor. It helps the body absorb vitamin B12 in the intestine. The Loss of parietal cells may be due to destruction by the bodys own immune system. 2.Complications are Nerve damage, digestive tract problems, heart, memory, confusion. 3. investigations are Serum folate, Iron and iron binding capacity, combined binding Luminescence tests