General Illness Information Common Name: ANEMIA, PERNICIOUS Medical Term: None Specified Description: This anemia is caused by lack of vitamin B-12 (cobalamin). It is a megaloblastic anemia . In this type of anemia the bone marrow produces large abnormal blood cells (megaloblasts). It often affects adults between the ages of 50 and 60. The symptoms of pernicious anemia develop slowly and gradually and may not be immediately recognized . This is because the liver stores large amounts of vitamin B12 and so the anemia does not develop for 2 to 4 years after the body stops absorbing vitamin B12. Vitamin B-12 is found in foods of animal origin, such as meat, fish, dairy products and legumes.. Causes: Prevention: See diagnosis and treatment below. Signs & Symptoms Weakness and tiredness Bleeding gums Nausea, appetite loss and weight loss Sore tongue Numbness and tingling in the hands and feet Difficulty maintaining balance Yellowish tinge to eyes and skin Shortness of breath Poor memory Headache Depression Confusion and dementia Risk Factors Improper diet, especially a vegetarian diet lacking vitamin B-12 and without supplements Thyroid disease Previous stomach surgery, stomach cancer or gastritis Bulimia or anorexia nervosa Diabetes mellitus Myxedema (a thyroid disorder) Family history of pernicious anemia Genetic factors. The disorder is most common in people of North European ancestry. It is rare in Blacks and Asians Diagnosis & Treatment General Measures: Diagnostic tests including blood tests, Schilling test (check's vitamin B-12 absorption), and occasionally, bone marrow biopsy are used to confirm the disease Follow recommended treatment guidelines that involve vitamin B-12 replacement. Since most people with pernicious anemia do not absorb vitamin B12 when taken by mouth - Vitamin B12 is given by intra-muscular injections. Initially the injections are given 2 to 3 times per week for several weeks until the blood levels of vitamin B12 return to normal levels and then injections are given once a month. These patients have to take vitamin B12 supplements for life Medications: Parenteral (Intramuscular) injections of Vitamin B12, starting weekly, and eventually monthly. Warning: Do not give folic acid supplements without Vitamin B12. Activity: Unlimited Diet: Diet rich in meant, legumes, unless contra-indicated. Possible Complications : Central nervous system changes may be permanent, if treatment is not started early. Gastric polyps. Stomach cancer. Prognosis This condition once diagnosed and appropriately treated is reversible.