Pernicious anaemia is a type of Vitamin B12 deficiency & is one kind of megaloblastic anaemia caused by the loss of gastric parietal cells which produce intrinsic factor which enables vitamin B12 to be absorbed in the ileum. A reduction in the number of these cells reduces the amount of vitamin B12 that is able to be absorbed. Insufficient production of gastric acid also reduces B12 absorption as this acid plays a part in the absorption process. Chronic gastritis can also lead to pernicious anaemia & there is, at the time of writing, some controversy about whether Helicobacter Pylori bacteria interferes with B12 absorption. Vitamin B12 is only provided by diet & cannot be synthesised in the body. Pernicious anaemia must not be confused with other types of B12 deficiency which have different causes.
Treatment is by intramuscular vitamin B12 injections. Never treat possible vitamin B12 deficiency with folate until it is certain that folate supplementation is also required otherwise this could worsen any existing central nervous system lesions.
The Schilling test used to be carried out to test for pernicious anaemia as opposed to other forms of B12 deficiency, although this is not used very often nowadays. Radioactive labelled Vitamin B12 is given & various tests performed to assess absorption.
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