Pernicious anemia associated with systemic lupus erythematosus

Area of Science:

• Internal Medicine
• Hematology
• Rheumatology

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
• Pernicious anemia is a condition of vitamin B12 deficiency due to impaired absorption.
• Autoimmune conditions can coexist and complicate disease management.

Observation:

• A young Black female diagnosed with SLE presented with symptoms suggestive of pernicious anemia.
• The patient exhibited a positive Schilling test, indicating malabsorption of vitamin B12.
• Intrinsic factor antibodies and low serum complement levels were detected, consistent with autoimmune processes.

Findings:

• The patient's Schilling test normalized following treatment with steroid therapy.
• Despite the improvement in vitamin B12 absorption, intrinsic factor antibodies persisted.
• Serum complement levels remained depressed throughout the observation period.

Implications:

• This case highlights a potential link between SLE and the development of pernicious anemia.
• Steroid therapy may effectively manage the hematological manifestations of pernicious anemia in SLE patients.
• The persistence of antibodies and complement depression suggests complex autoimmune interactions requiring further investigation.