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Pernicious Anemia: Basic Pathophysiology and Diagnostic Challenges in Neuropsychiatric Patients
Yin Mon Myat1, Kyaw Zin Thein2,3,4, Thein Hlaing Oo5
1Interfaith Medical Center, Brooklyn, NY 11213, USA.
Hematology Reports
|July 24, 2026
Summary
Pernicious anemia (PA) is hard to diagnose in neuropsychiatric patients, often presenting without anemia. Early detection requires better diagnostic tools to prevent neurological damage.
Area of Science:
- Neurology
- Hematology
- Psychiatry
Background:
- Pernicious anemia (PA) poses diagnostic challenges in neuropsychiatric patients.
- Symptoms like cognitive impairment and spinal cord degeneration can occur before anemia.
- Normal hematologic parameters can delay PA diagnosis.
Purpose of the Study:
- To review diagnostic complexities of PA in neuropsychiatric patients.
- To evaluate limitations of current diagnostic methods for cobalamin deficiency (CD).
- To highlight the need for improved, standardized diagnostic approaches.
Main Methods:
- Review of current literature on PA diagnosis in neuropsychiatric settings.
- Evaluation of limitations of biomarkers: serum cobalamin, MMA, Hcy, IFAs, PCAs.
- Analysis of diagnostic criteria variability.
Main Results:
- Neuropsychiatric symptoms may precede hematologic abnormalities in PA.
- Current biomarkers have limitations, especially in non-anemic patients.
- Lack of a gold standard test and variable criteria complicate diagnosis.
Conclusions:
- A comprehensive, standardized approach is needed for early PA detection.
- Clinical awareness and improved biomarker interpretation are crucial.
- Further research and improved protocols can prevent neurological damage.
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