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[Venous thromboembolism and hyperhomocysteinemia as first manifestation of pernicious anemia]

C Fernández-Miranda1, M Yebra Yebra, C Ribera Casado

  • 1Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid. cfmiranda@inicia.es

Revista Clinica Espanola
|October 22, 2005
PubMed

Insights

This study found pernicious anemia in 6.25% of patients with venous thromboembolism and hyperhomocysteinemia. Early diagnosis and vitamin B12 treatment can normalize homocysteine levels and prevent complications.

Area of Science:

  • Internal Medicine
  • Hematology
  • Clinical Biochemistry

Context:

  • Hyperhomocysteinemia is a known risk factor for thrombosis and atherosclerosis.
  • Vitamin B12 deficiency, often caused by pernicious anemia, is a primary contributor to hyperhomocysteinemia.
  • Identifying the prevalence of pernicious anemia in patients with venous thromboembolism (VTE) and hyperhomocysteinemia is crucial for understanding underlying causes.

Purpose:

  • To determine the prevalence of pernicious anemia in patients diagnosed with venous thromboembolism and hyperhomocysteinemia.
  • To investigate the clinical characteristics and diagnostic findings associated with pernicious anemia in this patient cohort.

Summary:

  • Eighty patients with VTE and elevated homocysteine levels (> 12 micromol/l) were evaluated.
  • Pernicious anemia was diagnosed in 5 patients (6.25%), identified through Schilling tests, antibody presence, and atrophic gastritis.
  • Only one patient exhibited macrocytic anemia, and thrombophilia studies were unremarkable in these cases.

Impact:

  • Although not highly prevalent, ruling out pernicious anemia is essential in VTE and hyperhomocysteinemia patients.
  • Timely diagnosis and oral vitamin B12 treatment normalized homocysteine and vitamin B12 levels within six months.
  • This highlights the importance of screening for pernicious anemia to prevent potential thrombotic and neurological sequelae.
Abstract

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