Related Experiment Videos
Pernicious anaemia patients should be screened for iron deficiency during follow up
1Department of Haematology, Hacettepe University Medical School, Ankara, Turkey.
Insights
Patients with pernicious anaemia (PA) frequently develop iron deficiency, particularly in older adults. Regular screening for iron deficiency is recommended for all PA patients, especially the elderly.
Area of Science:
- Gastroenterology
- Hematology
- Internal Medicine
Background:
- Pernicious anaemia (PA) is an autoimmune condition causing atrophic gastritis and vitamin B12 malabsorption due to a lack of intrinsic factor.
- Reduced gastric acid production (achlorhydria) in PA patients impairs dietary iron absorption.
- Age-related decline in gastric acidity may exacerbate iron absorption issues.
Purpose of the Study:
- To determine the prevalence of iron deficiency in patients diagnosed with pernicious anaemia.
- To investigate if the incidence of iron deficiency differs between younger and older PA patient cohorts.
- To assess changes in iron status during vitamin B12 therapy.
Main Methods:
- Ninety-five patients with pernicious anaemia underwent evaluation of body iron status.
- Patients were stratified into two age groups: under 60 years (n=53) and over 60 years (n=42).
- Iron deficiency was assessed at diagnosis and during follow-up, with comparisons made between age groups.
Main Results:
- Iron deficiency was a common comorbidity in patients with pernicious anaemia.
- The prevalence of iron deficiency was higher in the elderly group compared to the younger group.
- Iron deficiency increased in all patients during vitamin B12 therapy, with a more pronounced increase observed in the elderly.
Conclusions:
- Pernicious anaemia is associated with impaired iron absorption due to achlorhydria, leading to a high incidence of iron deficiency.
- Iron deficiency is more prevalent and pronounced in elderly patients with pernicious anaemia.
- Routine screening for iron deficiency at diagnosis and throughout follow-up is recommended for all pernicious anaemia patients, with particular attention to the elderly.
Aims:
To investigate if patients with pernicious anaemia (PA) are prone to develop iron deficiency and if there is a difference for this manifestation between younger and older age groups.
Methods:
Ninety-five patients with pernicious anaemia were evaluated for body iron status at the time of diagnosis and during follow up. Patients were also divided into two groups; younger than 60 (53 patients) and older than 60 (42 patients) years of age. Groups were compared for iron deficiency both at the time of diagnosis and at the end of follow up period.
Results:
Iron deficiency was a common finding in patients with pernicious anaemia. This deficiency state was more common in the elderly. During B12 therapy, iron deficiency increased in all groups, but the increased rate of iron deficiency was more prominent in the elderly patients.
Conclusion:
Pernicious anaemia is an atrophic gastropathy in which gastric parietal cells no longer produce hydrochloric acid. These patients with achlorhydria demonstrate impaired absorption of iron. On the other hand, with ageing, gastric acidity is already diminished. Iron deficiency commonly accompanies patients with pernicious anaemia and this is more pronounced in the elderly group. We suggest that all patients with pernicious anaemia, especially the elderly, should be screened for iron deficiency both at the beginning and during the follow up.