NationMaster - Encyclopedia: Pernicious anemia

Pernicious anemia (also known as Biermer's anaemia or Addison's anaemia or Addison-Biermer anaemia) is a form of megaloblastic anaemia due to vitamin B₁₂ deficiency dependent on impaired absorption of vitamin B₁₂ in the setting of atrophic gastritis, and more specifically of loss of gastric parietal cells. While the term "pernicious anaemia" is sometimes also incorrectly used to indicate megaloblastic anaemia due to any cause of vitamin B₁₂ deficiency, its proper usage refers to that caused by atrophic gastritis and parietal cell loss only. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Megaloblastic anemia is anemia resulting from a deficiency of vitamin B12 and folic acid. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... Atrophic gastritis is a process of chronic inflammation of the stomach mucosa, leading to loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... Parietal cells (also called oxyntic cells) are cells located in the stomach epithelium. ... Megaloblastic anemia is anemia resulting from a deficiency of vitamin B12 and folic acid. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ...

Mechanisms & manifestations

Pathophysiology

Vitamin B₁₂ cannot be produced by the human body, and must therefore be obtained from diet. Normally, dietary vitamin B₁₂ can only be absorbed by the ileum when it is bound by the intrinsic factor produced by parietal cells of the gastric mucosa. In pernicious anaemia, this process is impaired because of loss of parietal cells, resulting in insufficient absorption of the vitamin, which over a prolonged period of time ultimately leads to vitamin B₁₂ deficiency and thus megaloblastic anaemia. Grays Fig. ... Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. ... Parietal cells (also called oxyntic cells) are cells located in the stomach epithelium. ... In anatomy, the stomach is a bean-shaped hollow muscular organ of the gastrointestinal tract involved in the second phase of digestion, following mastication. ... The mucous membranes (or mucosa) are linings of ectodermic origin, covered in epithelium, that line various body cavities and internal organs. ...

Presentation

The presentation of pernicious anaemia resembles that of any other form of anaemia, but is often accompanied by the manifestations of vitamin B₁₂ deficiency (notably neurological abnormalities such as peripheral neuropathy), as well as by other manifestations of autoimmune atrophic gastritis. This article discusses the medical condition. ... Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... Peripheral neuropathy is the term for damage to nerves of the peripheral nervous system, which may be caused either by diseases of the nerve or from the side-effects of systemic illness. ...

Causes

Most commonly, the cause for impaired binding of vitamin B₁₂ by intrinsic factor is autoimmune atrophic gastritis, in which autoantibodies are directed against parietal cells (resulting in their loss) as well as againast the intrinsic factor itself (rendering it unable to bind vitamin B₁₂). Less frequently, loss of parietal cells may simply be part of a widespread atrophic gastritis of non-autoimmune origin, such as that frequently occurring in elderly people affected with long-standing chronic gastritis of any cause (including Helicobacter pylori infection). Note that forms of vitamin B₁₂ deficiency other than pernicious anaemia must be considered in the differential diagnosis of megaloblastic anaemia. Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Atrophic gastritis is a process of chronic inflammation of the stomach mucosa, leading to loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues. ... An autoantibody is an antibody (a type of protein) manufactured by the immune system that is directed against one or more of the individuals own proteins. ... Parietal cells (also called oxyntic cells) are cells located in the stomach epithelium. ... Intrinsic factor is a glycoprotein produced by the parietal cells of the stomach. ... Gastritis is inflammation of the gastric mucosa. ... Binomial name Helicobacter pylori ((Marshall 1985) Goodwin 1989) Helicobacter pylori is a helical shaped Gram-negative bacterium that colonises the mucus layer of gastric epithelium in the stomach, and also the duodenum when it has undergone gastric metaplasia. ... In medicine, differential diagnosis (sometimes abbreviated DDx or Î”Î”) is the systematic method physicians use to identify the disease causing a patients symptoms. ... Megaloblastic anemia is anemia resulting from a deficiency of vitamin B12 and folic acid. ...

Diagnosis

A diagnosis of pernicious anaemia first requires demonstration of megaloblastic anaemia (through a full blood count) and of its direct cause, vitamin B₁₂ deficiency (by measuring B₁₂ levels in serum). A Schillings test can then be used to distinguish pernicious anemia from other causes of vitamin B₁₂ deficiency (notably malabsorption. A diagnosis of atrophic gastritis should be confirmed by gastroscopy with biopsies. Approximately 90% of individuals with pernicious anemia have antibodies for parietal cells, however only 50% of individuals with these antibodies have pernicious anaemia. Megaloblastic anemia is anemia resulting from a deficiency of vitamin B12 and folic acid. ... A full blood count (FBC) or complete blood count (CBC) is a test requested by a doctor or other medical professional that gives information about the cells in a patients blood. ... A Schilling test is a test used to assess a patients capacity to absorb vitamin B12 from the bowel. ... Malabsorption is the state of impaired absorption of nutrients in the small intestine. ... Atrophic gastritis is a process of chronic inflammation of the stomach mucosa, leading to loss of gastric glandular cells and their eventual replacement by intestinal and fibrous tissues. ... In medicine (gastroenterology), esophagogastroduodenoscopy (EGD) or upper endoscopy is a diagnostic endoscopic procedure that visualises the upper part of the gastrointestinal tract. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Treatment

Being a manifestation of vitamin B₁₂ deficiency, pernicious anaemia is treated by administering vitamin B₁₂ supplements. Note that if oral tablets are chosen for this purposes, much higher doses are given than normally required in order to overcome the impaired absorption that characterises pernicious anaemia. If oral tablets are not sufficient, vitamin B₁₂ can also be administered via injection. Often the patient can learn to do this at home. Cobalamin or vitamin B12 is a chemical compound that is also known as cyanocobalamine. ... An injection is a method of putting liquid into the body with a hollow needle and a syringe which is pierced through the skin long enough for the material to be forced into the body. ...

History

The treatment for pernicious anemia was first devised by George Whipple who bled dogs to make them anemic and then fed them various substances to see what (if anything) would make them healthy again. He discovered that ingesting large amounts of liver seemed to cure the disease. George Minot and William Murphy then set about to chemically isolate the curative substance and ultimately were able to isolate the vitamin B₁₂ from the liver. For this, all three shared the 1934 Nobel Prize in Medicine. As a result, pernicious anemia is now treated with either vitamin B₁₂ injections, or large oral doses of vitamin B₁₂, typically between 2 and 4 mg daily. George Hoyt Whipple (August 28, 1878 â€“ February 1, 1976) was an American physician, biomedical researcher, and medical school educator and administrator. ... The liver is an organ present in vertebrates and some other animals. ... George Richards Minot (December 2, 1885 (Boston, Massachusetts, U.S.A.) - February 25, 1950) won the 1934 Nobel Prize in Physiology or Medicine with William P. Murphy and George H. Whipple for their work in the study of anemia. ... William Murphy may refer to: William Parry Murphy, Nobel prize winner William Beverly Murphy, food businessman William Murphy (bishop), Roman Catholic bishop in Rockville Centre, New York William F. Murphy, Jr. ... Year 1934 (MCMXXXIV) was a common year starting on Monday (link will display full 1934 calendar) of the Gregorian calendar. ... List of Nobel Prize laureates in Physiology or Medicine from 1901 to the present day. ...

Famous sufferers

Inez Milholland Inez Milholland Boissevain (born August 6, 1886 in Brooklyn, New York - November 25, 1916 in Los Angeles) was a suffragist, labor lawyer, World War I correspondent, and public speaker who greatly impacted the womens movement in America. ... Suffragette with banner, Washington DC, 1918 The title of suffragette (also occasionally spelled suffraget) was given to members of the womens suffrage movement in the United Kingdom. ... Alexander Graham Bell (3 March 1847 â€“ 2 August 1922) was a Scottish scientist, inventor, and innovator. ... Annie Oakley (August 13, 1860 â€“ November 3, 1926) b. ... (Helen) Beatrix Potter (28 July 1866 â€“ 22 December 1943) was an English author and illustrator, botanist, and conservationist, best known for her childrens books, which featured animal characters such as Peter Rabbit. ... Yoon, Eun-Hye (Korean: ìœ¤ì€í˜œ, Hanja: å°¹æ©æƒ , born October 3, 1984) is a South Korean actress, singer, and model. ... Madame Curie redirects here. ...

External links

Category: Hematology Pathology (from Greek pathos, feeling, pain, suffering; and logos, study of; see also -ology) is the study of the processes underlying disease and other forms of illness, harmful abnormality, or dysfunction. ... Hematology is the branch of medicine that is concerned with blood and its disorders. ... Although hematological malignancies are a form of cancer, they are generally treated by specialists in hematology, although in many hospitals oncology specialists also manage these diseases. ... A scanning electron microscope image of normal circulating human blood. ... This article is about lymphoma in humans. ... Leukemia or leukaemia (see spelling differences) is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation (production by multiplication) of blood cells, usually white blood cells (leukocytes). ... Leukocytosis is an elevation of the white blood cell count (the leukocyte count) above the normal range. ... Lymphocytosis is an increase in the number of lymphocytes in the blood. ... Monocytosis is an increase in the number of circulating monocytes. ... Lymphopenia is the condition in which there exists an abnormally low number of lymphocytes in the blood. ... Neutropenia (or neutropaenia, adjective neutrop(a)enic) is a hematological disorder characterized by an abnormally low number of neutrophil granulocytes (a type of white blood cell). ... Human red blood cells Red blood cells are the most common type of blood cell and the vertebrate bodys principal means of delivering oxygen from the lungs or gills to body tissues via the blood. ... Anemia (AmE) or anÃ¦mia (BrE), from the Greek () meaning without blood, is a deficiency of red blood cells (RBCs) and/or hemoglobin. ... Hemoglobinopathy is a kind of genetic defect that results in abnormal structure of one of the globin chains of the hemoglobin molecule. ... Iron deficiency anemia is the most common type of anemia, and the most common cause of microcytic anemia. ... The Plummer-Vinson syndrome, also called Paterson-Kelly syndrome or sideropenic dysphagia is a disorder linked to severe, long-term iron deficiency anemia, which causes swallowing difficulty (dysphagia) due to web-like membranes of tissue growing in the throat (esophageal webs). ... Megaloblastic anemia is an anemia (of macrocytic classification) which results from a deficiency of vitamin B12 and folic acid. ... Hemolytic anemia is anemia due to hemolysis, the abnormal breakdown of red blood cells either in the blood vessels (intravascular hemolysis) or elsewhere in the body (extravascular). ... Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive hereditary disease featuring nonimmune hemolytic anemia in response to a number of causes. ... Thalassemia (American English) or thalassaemia (British English) is a recessive trait inherited disease of the red blood cells. ... Sickle-cell disease is a group of genetic disorders caused by sickle hemoglobin (Hgb S or Hb S). ... Sickle cell trait describes the way a person can inherit some of the genes of sickle cell disease, but not develop symptoms. ... Hereditary spherocytosis is a genetic disorder of the red blood cells that makes them prone to hemolysis. ... Hereditary elliptocytosis is a blood disorder in which 50-90% of the red blood cells consist of rod forms and elliptocytes (that is, elliptical erythrocytes); often associated with a hemolytic anemia. ... Hereditary stomatocytosis describes a number of inherited autosomal dominant human conditions which affect the red blood cell, in which the membrane or outer coating of the cell leaks sodium and potassium ions. ... Warm Autoimmune Hemolytic Anemia (warm AIHA) is the most common of the autoimmune hemolytic diseases. ... In medicine, Hemolytic-uremic syndrome (or haemolytic-uraemic syndrome, abbreviated HUS) is a disease characterised by microangiopathic hemolytic anemia, acute renal failure and a low platelet count (thrombocytopenia). ... In medicine (hematology) microangiopathic hemolytic anemia (MAHA) is a subgroup of hemolytic anemia (anemia, loss of red blood cells through destruction) caused by factors in the small blood vessels. ... Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired life-threatening disease of the blood characterised by hemolytic anemia, thrombosis and red urine due to breakdown of red blood cells. ... Aplastic anemia is a condition where bone marrow does not produce sufficient new cells to replenish blood cells. ... Acquired pure red cell aplasia (or PRCA) refers to a type of anemia affecting the precursors to red blood cells but not to white blood cells. ... Diamond-Blackfan anemia (DBA) is a congenital erythroid aplasia that usually presents in infancy. ... Fanconi anemia (FA) is a genetic disease that affects children and adults from all ethnic backgrounds. ... Sideroblastic anemia is caused by the abnormal production of red blood cells as part of myelodysplastic syndrome, which can evolve into hematological malignancies (especially acute myelogenous leukemia). ... Haemochromatosis, also spelled hemochromatosis, is a hereditary disease characterized by improper processing by the body of dietary iron which causes iron to accumulate in a number of body tissues, eventually causing organ dysfunction. ... Coagulation is a complex process by which blood forms solid clots. ... A 250 ml bag of newly collected platelets. ... This page is a candidate to be moved to Wiktionary. ... Disseminated intravascular coagulation (DIC) is a pathological process in the body where the blood starts to coagulate throughout the whole body. ... This article does not cite any references or sources. ... Haemophilia A (also spelt Hemophilia A or HÃ¦mophilia A) is a blood clotting disorder caused by a mutation of the factor VIII gene, leading to a deficiency in Factor VIII. It is the most common hemophilia. ... Haemophilia B (also spelled Hemophilia B or Hæmophilia B) is a blood clotting disorder caused by a mutation of the Factor IX gene. ... A mild form of hemophilia that mainly occurs in Jews of Ashkenazi descent. ... Factor XIII or fibrin stabilizing factor is an enzyme (EC 2. ... Von Willebrand disease (vWD) is the most common hereditary coagulation abnormality described in humans, although it can also be acquired as a result of other medical conditions. ... Purple discolorations on the skin caused by bleeding underneath the skin. ... In medicine (rheumatology and pediatrics) Henoch-SchÃ¶nlein purpura (HSP, also known as allergic purpura) is a systemic vasculitis characterized by prominent tissue deposition of IgA-containing immune complexes, especially in the skin and kidney. ... Idiopathic thrombocytopenic purpura (ITP) is the condition of having a low platelet count (thrombocytopenia) of no known cause (idiopathic). ... Thrombotic thrombocytopenic purpura (TTP or Moschcowitz disease) is a rare disorder of the blood coagulation system that in most cases arises from the deficiency or inhibition of the enzyme ADAMTS13, which is responsible for cleaving large multimers of von Willebrand factor. ... Bernard-Soulier syndrome (BSS, named after Jean Bernard and Jean Pierre Soulier) is a rare congenital bleeding disorder characterized by thrombocytopenia and large platelets and was first described in 1948. ... Glanzmanns thrombasthenia is an extremely rare, autosomal recessive disorder of the blood, in which the platelets lack GPIIb/IIIa. ... Grey platelet syndrome is a rare condition caused by a reduction or absence of the platelet alpha-granules in blood platelet, or of the proteins contained in these granules. ... Though histiocytosis can refer to any of several specific diseases, the term is generally used to refer to a rare blood disease that is caused by an excess of white blood cells called histiocytes. ... Acute monocytic leukemia (AMoL, or AML-M5) is considered a type of acute myeloid leukemia. ... Malignant histiocytosis is a hereditary disease found in the Bernese Mountain Dog characterized by histiocytic infiltration of the lungs and lymph nodes. ... Erdheim-Chester disease (also known as Erdheim-Chester syndrome) is a rare form of non-Langerhans-cell histiocytosis. ... This article or section is in need of attention from an expert on the subject. ... Juvenile xanthogranuloma is a form of histiocytosis, classified as non-Langerhans cell histiocytosis,[1] or more specifically, type 2.[2] ^ Nakasu S, Tsuji A, Fuse I, Hirai H. Intracranial solitary juvenile xanthogranuloma successfully treated with stereotactic radiosurgery. J Neurooncol. ... Hemophagocytic lymphohistiocytosis is a form of histiocytosis where there is an excess of both histiocytes and lymphocytes. ... Asplenia refers to the absence (a-) of normal spleen function and is associated with some risks. ... // Methemoglobinemia, also known as met-Hb, is a disorder characterized by the presence of a higher than normal level of methemoglobin in the blood. ...

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