A 45–year–old black female presented with 2 weeks history of worsening fatigue, malaise, shortness of breath upon exertion and dizziness. She also reported irregular menstrual periods. [shmabstracts.com]

She is presently doing well without evidence of carcinoma relapse or metastasis. [ci.nii.ac.jp]

Before surgery, two patients (6.6%) presented ferropenic anemia. Iron deficiency was seen in 40 and 54.5% 2 and 3 years after surgery, respectively. Cobalamin deficiency was observed in 33.3% at 2 years and in 27.2% at 3 years. [ncbi.nlm.nih.gov]

Also, a rare, form of pernicious anemia called congenital pernicious anemia is present at birth. Pernicious anemia is a form of megaloblastic anemia. [emedicinehealth.com]

Ovalocytes (oval-shaped RBCs) are present Howell-Jolly bodies (chromosomal remnant) also present Peripheral smear images Images hosted on other servers: Hypersegmented neutrophil Macrocytes, macro-ovalocytes, nucleated RBCs and hypersegmented neutrophils [pathologyoutlines.com]

• Anemia

  Other dietary vitamin B12 deficiency anemia D51.8 Other vitamin B12 deficiency anemias D51.9 Vitamin B12 deficiency anemia, unspecified D52 Folate deficiency anemia D52.0 Dietary folate deficiency anemia D52.1 Drug-induced folate deficiency anemia D52.8 [icd10data.com]

  […] deficiency anemia Vitamin B12 deficiency anemia due to dietary cause Vitamin B12 deficiency anemia due to dietary causes Vitamin B12 deficiency anemia due to malabsorption with proteinuria 281.1 Excludes Applies To Anemia: vegan's vitamin B12 deficiency [icd9data.com]

  NIH: National Heart, Lung, and Blood Institute Anemia (Medical Encyclopedia) Anemia - B12 deficiency (Medical Encyclopedia) Anemia caused by low iron -- infants and toddlers (Medical Encyclopedia) Anemia of chronic disease (Medical Encyclopedia) Anemia [icdlist.com]

  The ICD code D510 is used to code Pernicious anemia Pernicious anemia (also known as vitamin B12 deficiency anemia, Biermer's anemia, Addison's anemia, or Addison–Biermer anemia) is one of many types of the larger family of megaloblastic anemias. [icd.codes]

• Amyloidosis

  […] protease (eg, chronic pancreatitis, Zollinger-Ellison syndrome [ZES]) Bacterial overgrowth in intestine (eg, blind loop, diverticula) - bacteria compete with the body for cobalamin Disorders of ileal mucosa (eg, resection, ileitis, sprue, lymphoma, amyloidosis [emedicine.medscape.com]

• Diarrhea

  As the anemia becomes worse, symptoms may include weakness, fatigue, diarrhea or constipation, numbness or tingling in the fingers and toes, poor sense of balance, thinking and memory problems, and/or depression. [instituteofliving.org]

  Symptoms can include: Diarrhea or constipation Fatigue, lack of energy, or lightheadedness when standing up or with exertion Loss of appetite Pale skin Feeling irritable Shortness of breath, mostly during exercise Swollen, red tongue or bleeding gums [medlineplus.gov]

  Symptoms of a B12 deficiency include fatigue, diarrhea, pale skin, loss of appetite and shortness of breath. If left untreated, it can cause nerve problems characterized by tingling and numbness in your hands and feet, depression and confusion. [woman.thenest.com]

  […] blood pressure, pallor, depression, muscle weakness and shortness of breath (known as ‘the sighs’) Sore tongue Low grade fevers Difficulty in proprioception Difficulty concentrating and sluggish responses, |brain fog Neuropathic pain Heartburn, nausea, diarrhea [revivelifelab.com]

  Other cells with high turnover rate are also affected by these abnormalities which may explain the redness and increased pain in the tongue and diarrhea (Bruyere, 2009). Caucasian patients with B12 deficiency present with a lemon-yellow skin color. [wikilectures.eu]

• Jaundice

  A physician should also be contacted if the tongue becomes slick or smooth or the patient: bruises or tires easily feels ill for more than five days feels weak or out of breath looks pale or jaundiced. [diagnose-me.com]

  Patient has been inspected as lemon-colored skin and sclera jaundice ( Figure 1 ). Figure 1: Skin and sclera jaundice of patient. [omicsonline.org]

  Difficulty concentrating and sluggish responses, |brain fog Neuropathic pain Heartburn, nausea, diarrhea, impaired urination, weight loss Unsteady gait, clumsiness, loss of sensation in the feet Pins and needles sensations or numbness in fingers or toes Jaundice [revivelifelab.com]

  Symptoms include the following: progressive fatigue shortness of breath heart palpitations weakness glossitis (inflammation of the tongue) nausea anorexia headache fainting irritability forgetfulness pallor slight jaundice Conventional treatment consists [innvista.com]

  Mild enlargement of the liver (hepatomegaly) and a slight yellowing of the skin or eyes (jaundice) may also occur. Megaloblastic anemia resulting from cobalamin deficiency may also be associated with neurological symptoms. [rarediseases.org]

• Palpitations

  General symptoms of anaemia may include: extreme tiredness (fatigue) lack of energy (lethargy) breathlessness feeling faint headaches pale skin noticeable heartbeats (palpitations) hearing sounds coming from inside the body, rather than from an outside [nhs.uk]

  Review Topic QID: 104747 M2 Select Answer to see Preferred Response PREFERRED RESPONSE 1 (M2.HE.4686) A 63-year-old female complains of weakness, light-headedness, palpitations, and soreness of the tongue. [medbullets.com]

  When To Call A Professional Contact your doctor for a physical examination if you experience unexplained fatigue, palpitations, shortness of breath, sore tongue or any other symptoms of vitamin B12 deficiency. [drugs.com]

  They include paleness, fatigue, shortness of breath, and palpitations, or heart fluttering, particularly if you exert yourself. In both disorders, your mouth and tongue may be sore, and your skin may become yellow in color. [revivelifelab.com]

  […] down the spine while rotating the head, also known as Lhermitte’s sign Ataxia Increased unsteadiness on feet while eyes are closed, also known as Romberg’s sign Hematological Symptoms: Megaloblastic anemia Pancytopenia Cardiovascular Symptoms: Heart palpitations [b12patch.com]

• Hypertension

  After controlling for cardiovascular risk factors, including smoking and hypertension and intake of alcohol, fiber, vitamin E, and saturated, polyunsaturated, and trans fat, the relative risks (RRs) of CHD between extreme quintiles were 0.69 (95% confidence [moyak.com]

• Hyperpigmentation

  (1 - 2 mg) are given by mouth, its absorption does not rely on the presence of intrinsic factor or an intact ileum - the free crystalline B12 is absorbed along the entire intestine by passive diffusion Clinical images Images hosted on other servers: Hyperpigmentation [pathologyoutlines.com]

  Clinical Manifestations of Vitamin B 12 Deficiency Cutaneous Hyperpigmentation Vitiligo Gastrointestinal Glossitis Jaundice Hematologic Anemia (macrocytic, megaloblastic) Thrombocytopenia Neuropsychiatric Cognitive impairment Gait abnormalities Irritability [aafp.org]

• Fracture

  Mizrahi MD, Emilia Lubart MD and Arthur Leibovitz MD, low Borderline levels of serum vitamin B12 may Predict cognitive Decline in elderly hip Fracture Patients, IMAJ 2017; 19: 305–308 Yunsoo Soh, MD, PhD, Do Hun Lee, MD, Chang Won Won, MD, PhD, Association [revistamedicasinergia.com]

  These symptoms dramatically increase the risk of falls, which, in turn, lead to trauma (ie, fractures, subdural hematomas), hospital stays, loss of independence, nursing home placement, and premature death. [pharmacytimes.com]

  Fractures. Muscular spasms and cramps. Bleeding from the gums (gingival bleeding). Oral ulcers. Brittle nails. Decreased activity of osteoblasts (cells that build bone). Restless legs. Weakness of legs, arms, trunk. Glossitis, swollen/sore tongue. [regevelya.com]

• Irritability

  Symptoms include weak muscles, numbness, trouble walking, nausea, weight loss, irritability, fatigue, and increased heart rate. Treatment may include vitamin B 12 supplements. It is also important to eat a well-balanced diet. [hopkinsmedicine.org]

  […] iron, folic acid or vitamin B12 Blood disorders such as sickle cell anemia and thalassemia, or cancer Aplastic anemia, a condition that can be inherited or acquired G6PD deficiency, a metabolic disorder Anemia can make you feel tired, cold, dizzy, and irritable [icdlist.com]

  […] caused by a vitamin B12 deficiency, you may have other symptoms, such as: a pale yellow tinge to your skin a sore and red tongue (glossitis) mouth ulcers pins and needles (paraesthesia) changes in the way that you walk and move around disturbed vision irritability [nhs.uk]

  Symptoms can include: Diarrhea or constipation Fatigue, lack of energy, or lightheadedness when standing up or with exertion Loss of appetite Pale skin Feeling irritable Shortness of breath, mostly during exercise Swollen, red tongue or bleeding gums [medlineplus.gov]

  […] caused by the anemia (shortness of breath, fatigue, and weakness) plus paresthesias, loss of deep tendon reflexes, long tract signs, impaired proprioception and vibratory senses, unsteady gait, spastic paraplegia, loss of sphincter control, memory loss, irritability [thebigl.co]

• Ataxia

  On physical exam, there is often a positive Rhombergs sign along with sensory ataxia and loss of vibration and position sensation. [thebigl.co]

  The result of myelin degeneration includes neurologic complications, paresthesias of the hands and feet, lost of vibratory sensations in the arms and legs and ultimately, ataxia (Bruyere, 2009). [wikilectures.eu]

  […] vibration or position sense, impaired pain or touch perception Paresthesia Combined systems disease Decreased reflexes Unexplained vision or taste impairment Electric-like shocks down the spine while rotating the head, also known as Lhermitte’s sign Ataxia [b12patch.com]

  100 fL with ovalocytosis, possibly in conjunction with thrombocytopenia and neutropenia > pancytopenia) neutrophil hypersegmentation (at least 5% of neutrophils with 5 lobes or at least 1% with 6 lobes), and neurologic manifestations (paresthesias and ataxia [clinicaladvisor.com]

  Pregnant women with low or marginal levels of vitamin B 12 are at increased risk of having children with neural tube defects. 10 Exclusively breastfed children of mothers with vitamin B 12 deficiency are at increased risk of failure to thrive, hypotonia, ataxia [aafp.org]

Thus, pernicious anemia must be differentiated from other disorders that interfere with the absorption and metabolism of vitamin B-12 (see DDx and Workup ). [emedicine.medscape.com]

The goal of treatment is to increase your vitamin B12 level. Treatment may include a shot of vitamin B12 once a month. If you have a very low level of B12, you may need more shots in the beginning. [medlineplus.gov]

What Is the Medical Treatment for Pernicious Anemia (Vitamin B-12 Deficiency)? Medical treatment is the mainstay of treatment for pernicious anemia and consists of vitamin B-12 preparations to replenish vitamin B-12 stores. [emedicinehealth.com]

Paraoxonase and arylesterase activities significantly increased after treatment with vitamin B(12) in vitamin B(12) deficiency anemia; however, there were no significant changes in the activities of these enzymes after iron treatment in iron deficiency [ncbi.nlm.nih.gov]

Treatment may include vitamin B 12 shots (injections) and folic acid pills. [hopkinsmedicine.org]

Treatment is corticosteroid therapy, therapeutic splenectomy in case who failed to respond to treatment. It has been often noted that most of cases are female [ 6 ]. [omicsonline.org]

What Is the Prognosis for Pernicious Anemia (Vitamin B-12 Deficiency)? Pernicious anemia is easily and effectively treated by the administration of vitamin B-12. Lifelong treatment is required. [emedicinehealth.com]

Prognosis The outlook is excellent because this form of anemia responds well to treatment. However, it is possible that nerve cell damage will be permanent. [drugs.com]

In general, the prevalence of pernicious anemia is probably underestimated, due to the complexity of the diagnosis. [6] Prognosis The disease is called pernicious anemia because it was fatal prior to the discovery that it was a nutritional disorder. [emedicine.medscape.com]

[…] for PA has been intramuscular injections of cobalamin in the form of cyanocobalamin (CN-Cbl), hydroxocobalamin (OH-Cbl) or methylcobalamin. [47] Oral doses [ edit ] Treatment with high-dose vitamin B 12 orally also appears effective. [47] [48] [49] Prognosis [en.wikipedia.org]

If the urine level rises greater than 8% in the second phase, pernicious anemia is the underlying etiology. [thebigl.co]

The eradication of H pylori was associated with recovery from anemia and increased serum vitamin B12 level (P CONCLUSIONS: H pylori seems to be an etiologic factor in vitamin B12 deficiency, since anemia was cured and the level of vitamin B12 in the serum [ncbi.nlm.nih.gov]

Case 35-year-old male patient who was Syria refugees and consulted with us due anemia and etiology of pancytopenia by internal medicine service has been admitted and examined by hematology ward. [omicsonline.org]

Children who develop cobalamin deficiency usually have a hereditary disorder, and the etiology of their cobalamin deficiency is different from the etiology observed in classic pernicious anemia. [emedicine.medscape.com]

[…] and thymidine synthesis, myelin production, protein / neurotransmitters / fatty acid / phospholipid production and DNA methylation, which becomes deficient in these individuals Methylmalonyl-CoA to succinyl-CoA also requires Vitamin B12 as a cofactor Etiology [pathologyoutlines.com]

Section, Division of Epidemiology, Statistics, and Prevention Research, 6100 Building, Room 7B03, NICHD, NIH, DHHS, Bethesda, MD 20892. [ajcn.nutrition.org]

Definition / general Vitamin B12 deficiency, also known as hypocobalaminemia, refers to low blood levels of vitamin B12 Epidemiology 6% of those under age 60 and 20% over age 60 Rates may be as high as 80% in parts of Africa and Asia Pathophysiology Total [pathologyoutlines.com]

Epidemiology: - Individuals older than 30 - Northern European descent (primarily Scandinavian, English and Irish) - More likely in females (black females having earlier onset) (McCance, Heuther, Brashers & Rote, 2014) Disease described: Vitamin B12 deficiency [wikilectures.eu]

Epidemiology The adult form of pernicious anemia is most prevalent among individuals of either Celtic (ie, English, Irish, Scottish) or Scandinavian origin. In these groups, 10-20 cases per 100,000 people occur per year. [emedicine.medscape.com]

An association has been observed between pernicious anemia and certain types of gastric cancer, but a causal link has not been established. [27] Epidemiology [ edit ] PA is estimated to affect 0.1% of the general population and 1.9% of those over 60, [en.wikipedia.org]

Detailed pathophysiology at cellular, tissue, organ and systems levels: Cobalamines come from the family of Vitamin B12 and is a cofactor for intra-cellular biochemical reactions. [wikilectures.eu]

Definition / general Vitamin B12 deficiency, also known as hypocobalaminemia, refers to low blood levels of vitamin B12 Epidemiology 6% of those under age 60 and 20% over age 60 Rates may be as high as 80% in parts of Africa and Asia Pathophysiology Total [pathologyoutlines.com]

Pathophysiology Classic pernicious anemia is caused by the failure of gastric parietal cells to produce sufficient IF (a gastric protein secreted by parietal cells) to permit the absorption of adequate quantities of dietary vitamin B-12. [emedicine.medscape.com]

[…] indicated that the formation of antibodies to gastric cells was autosomal dominant gene determined, and the presence of antibodies to the gastric cells might not be necessarily related to the occurrence of atrophic gastritis related to PA. [32] [34] Pathophysiology [en.wikipedia.org]

How Do You Prevent Pernicious Anemia (Vitamin B-12 Deficiency)? Pernicious anemia develops as a result of an autoimmune process in the body and cannot be prevented. The effects of pernicious anemia can be prevented by replacing the B-12 in the body. [emedicinehealth.com]

You can prevent anemia caused by a lack of vitamin B12 by eating a well-balanced diet. Shots of vitamin B12 can prevent anemia after surgeries known to cause vitamin B12 deficiency. [medlineplus.gov]

Can pernicious anemia/ vitamin B-12 deficiency be prevented? The autoimmune process that causes pernicious anemia cannot be prevented. [medicinenet.com]

Prevention of anemia Prevention of anemia (4): In infants and preschool children anemia can be prevented by encouraging exclusive breast feeding of infants (without supplementary liquids, water, formula or food) for four to six months after birth. [news-medical.net]

CONCLUSION: Our routine scheme of vitamin supplementation is not sufficient to prevent iron and vitamin B12 deficiencies in most patients. [ncbi.nlm.nih.gov]