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Pernicious anemia. From past to present.

E Rodríguez de Santiago1, C Ferre Aracil1, A García García de Paredes1

  • 1Servicio de Gastroenterología, Hospital Universitario Ramón y Cajal, Madrid, España.

Revista Clinica Espanola
|February 15, 2015
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Summary

Pernicious anemia, the main cause of vitamin B12 deficiency, stems from autoimmune gastritis destroying parietal cells. This review examines current debates on its diagnosis, H. pylori role, and treatment.

Keywords:
Anemia perniciosaAnticuerpos anticélula parietalAnticuerpos antifactor intrínsecoB12 oralFactor intrínsecoGastric adenocarcinoma riskHelicobacter pyloriHomocisteínaHomocysteineIntrinsic factorIntrinsic factor antibodiesMethylmalonic acidOral vitamin B12Parietal cell antibodiesPernicious anemiaRiesgo adenocarcinoma gástricoVitamin B12Vitamina B12Ácido metilmalónico

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Area of Science:

  • Gastroenterology
  • Immunology
  • Hematology

Background:

  • Pernicious anemia is the leading cause of vitamin B12 deficiency in Western nations.
  • It is characterized by autoimmune chronic atrophic gastritis, leading to parietal cell destruction.
  • This destruction impairs intrinsic factor production, crucial for vitamin B12 absorption in the ileum.

Purpose of the Study:

  • To review current advancements and ongoing debates in pernicious anemia.
  • To analyze the evolving understanding of the disease's pathophysiology and clinical management.
  • To discuss contemporary issues including H. pylori, autoantibodies, diagnostic utility of B12 levels, and treatment.

Main Methods:

  • Literature review of recent advances in pernicious anemia research.
  • Analysis of diagnostic markers such as parietal cell antibodies and intrinsic factor antibodies.
  • Evaluation of the role of Helicobacter pylori infection.
  • Assessment of oral vitamin B12 treatment efficacy and risks.

Main Results:

  • Recent decades have seen renewed interest in pernicious anemia due to new research.
  • The role of H. pylori, diagnostic antibody tests, and serum vitamin B12 levels are subjects of ongoing discussion.
  • The review covers risks of gastric adenocarcinoma and carcinoids associated with the condition.

Conclusions:

  • Pernicious anemia remains a significant health concern, necessitating updated understanding.
  • Current research is clarifying the complex interplay of factors influencing its development and management.
  • Effective diagnosis and treatment strategies are crucial for managing associated risks and improving patient outcomes.