Pernicious anemia is a type of vitamin B12 anemia. The body needs vitamin B12 to make red blood cells. You get this vitamin from eating foods such as meat, poultry, shellfish, eggs, and dairy products.
A special protein, called intrinsic factor, helps your intestines absorb vitamin B12. This protein is released by cells in the stomach. When the stomach does not make enough intrinsic factor, the intestine cannot properly absorb vitamin B12.
Common causes of pernicious anemia include:
Weakened stomach lining (atrophic gastritis)
An autoimmune condition in which the body's immune system attacks intrinsic factor protein or the cells that make it.
Very rarely, pernicious anemia is passed down through families. This is called congenital pernicious anemia. Babies with this type of anemia do not make enough intrinsic factor or cannot properly absorb vitamin B12 in the small intestine.
In adults, symptoms of pernicious anemia are usually not seen until after age 30. The average age of diagnosis is age 60.
You are more likely to get this disease if you:
Scandinavian or Northern European
Have a family history of the condition
Certain diseases can also raise your risk. They include:
A woman with low B12 levels may have a false positive Pap smear. That's because a vitamin B12 deficiency affects the cells certain cells, called epithelial cells, look.
Treatment
The goal of treatment is to increase your vitamin B12 levels.
Treatment involves a shot of vitamin B12 once a month. Persons with severely low levels of B12 may need more shots in the beginning.
Some patients may also need to take vitamin B12 supplements by mouth. For some people, high-dose vitamin B12 tablets taken by mouth work well, and shots are not needed.
A certain type of vitamin B12 may be given through the nose.
Your doctor or nurse will also recommend eating a well-balanced diet.
Expectations (prognosis)
Patients usually do well with treatment.
It is important to start treatment early. Nerve damage can be permanent if treatment does not start within 6 months of symptoms.
Complications
People with pernicious anemia may have gastric polyps, and are more likely to develop gastric cancer and gastric carcinoid tumors.
Brain and nervous system problems may continue or be permanent if treatment is delayed.
Calling your health care provider
Call your health care provider if you have symptoms of vitamin B12 deficiency.
Prevention
There is no known way to prevent this type of vitamin B12 anemia. However, early detection and treatment can help reduce complications.
References
Antony AC. Megaloblastic anemias. In: Hoffman R, Benz EJ, Shattil SS, et al., eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 39.
Review Date:
2/8/2012
Reviewed By:
Todd Gersten, MD, Hematology/Oncology, Palm Beach Cancer Institute, West Palm Beach, FL. Review provided by VeriMed Healthcare Network. Also reviewed by Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington; David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
