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[Pernicious anemias with subtle or atypical presentation].

A Remacha1, J C Souto, F Ortuño

  • 1Serveis d'Hematologia i de Patologia Digestiva, Hospital de la Santa Creu i Sant Pau, Barcelona.

Sangre
|April 1, 1992
PubMed
Summary

Pernicious anaemia (PA) can present atypically without macrocytosis, affecting 12.1% of patients. Early suspicion and diagnosis are crucial for patients with subtle signs of PA.

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Area of Science:

  • Hematology
  • Gastroenterology
  • Immunology

Background:

  • Pernicious anaemia (PA) is an autoimmune condition causing vitamin B12 deficiency due to lack of intrinsic factor.
  • Typical PA presentation includes macrocytosis and anaemia, but atypical forms exist.

Purpose of the Study:

  • To determine the prevalence of pernicious anaemia (PA) with subtle or atypical onset.
  • To characterize the clinical and biological features of these atypical PA cases.

Main Methods:

  • Reviewed 124 patients diagnosed with PA based on serum vitamin B12 deficiency and absent intrinsic factor secretion.
  • Identified patients lacking macrocytosis (MCV < 98 fL) but with low serum B12 (< 150 pmol/L).

Main Results:

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  • 12.1% (15/124) of PA patients lacked macrocytosis.
  • These patients presented with varied hematological findings, including concurrent iron deficiency or normal blood counts.
  • Investigations were prompted by neuropsychiatric symptoms, polycythemia, or positive anti-parietal cell antibodies.

    • Conclusions:

    • Atypical pernicious anaemia (PA) presentation is likely underestimated.
    • Clinicians should suspect and rule out PA in patients exhibiting subtle or atypical clinical and biological characteristics.