Pernicious
Anaemia
It is also known as megaloblastic anaemia.
Causes
1.Dietary deficiency of vitamin B12.
2.Deficiency of the intrinsic factor
required for absorption of vitamin B12.
Clinical
features
1.Age:>40years.
2.Sex:male=female.
3.Features of anaemia.
4.Severe stomatitis and glossitis.
5.Smooth tongue.
6.Mild trouble.
7.Neurological features may sometimes be
seen.
.Ataxia.
.Tingling and numbness of the
hands and feet.
Investigations
1.As discussed under ‘anaemia’.
2.Achlorhydria on fractional test meal.
3.Hypochromic,macrocytic anaemia.
4.Leucopenia.
5.Bone marrow:megaloblasts.
Treatment
|
Type of treatment |
Treatment |
|
Replacement of deficiency |
.Cyanocobalamine(Vitamin B12)1000 micrograms IM once or twice a a
week. .Folic acid along with vitaminB12. It is never given alone because
that may result in the vitamin B12 getting used up so that its deficiency
develops and the patient develops subacute combined degeneration. |
|
Definitive treatment |
.Vitamin B12 250 micrograms IM once in two weeks or once a month. |
|
Instructions to the patient |
.Not to stop treatment even when he gets well. .Have a check-up periodically. |
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