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Jun 18 2019

Morning Report: Pernicious Anemia

Thank you Dr. Kumar for an excellent case presentation on vitamin B12 deficiency secondary to pernicious anemia in a patient with Graves’ disease and Vitiligo.

Key Learning Points:

  • Remember: B12 (cobalamin) levels are neither sensitive nor specific for the diagnosis of B12 deficiency
  • Expect to see elevated methylmalonic acid and/or homocysteine levels
  • Test for pernicious anemia if there is B12 deficiency and suspicion for other underlying autoimmune disease
  • Diagnosis of pernicious anemia is made by testing Intrinsic Factor Ab
  • Outcomes if neurological symptoms: expect to see recovery in appx 1 week and resolution in 6-12 weeks. Symptoms may be irreversible if diagnosis is delayed

For more information, see this review article below for a comprehensive overview of pernicious anemia:

Pernicious Anemia – NEJM

Vitamin b12 deficiency – NEJM

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