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[Pernicious anemia with indicanuria].

H Yamauchi, N Tsukamoto, H Katahira

    [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
    |April 1, 1989
    PubMed
    Summary

    A patient with pernicious anemia presented with unusually high levels of indican in her urine, a condition known as indicanuria. This finding suggests a potential link between pernicious anemia and altered gut bacteria metabolism.

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    Area of Science:

    • Biochemistry
    • Gastroenterology
    • Clinical Medicine

    Background:

    • Pernicious anemia is an autoimmune condition affecting the stomach, leading to vitamin B12 deficiency.
    • Classic diagnostic markers for pernicious anemia include low vitamin B12, abnormal deoxyuridine suppression tests, methylmalonic aciduria, and positive anti-intrinsic factor antibodies.

    Observation:

    • A 67-year-old female diagnosed with pernicious anemia incidentally exhibited green-colored urine during hospitalization.
    • Diagnostic tests confirmed significant indicanuria, with dark purple crystalline material identified as indoxylsulphate potassium salt.
    • The patient's daily output of this substance was approximately 50 times the normal level.

    Findings:

    • The patient presented with classical pernicious anemia and concurrent, markedly elevated urinary indoxylsulphate.

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  • No increased urinary excretion of monoamino-monocarboxylic amino acids was observed.
  • The specific etiology for the severe indicanuria in the context of pernicious anemia remained undetermined.

    • Implications:

    • This case highlights an unusual metabolic finding in a patient with pernicious anemia.
    • Further investigation is warranted to explore potential links between pernicious anemia, gut microbiome alterations, and indicanuria.
    • Understanding this association may offer new insights into the complex pathophysiology of pernicious anemia and related metabolic disturbances.