Abstract Body

Background and purpose

Pernicious anemia (PA), also known as Addison-Biermer disease, is a type of megaloblastic anemia caused by autoimmune gastritis or chronic atrophic gastritis type A, characterized by the destruction of the gastric mucosa, especially the fundic mucosa. The differential diagnosis includes Vitamin B12 deficiency and Celiac disease.

A 47-year-old patient who consulted for recurrent oral thrush for a year. Uninteresting personal history. First analysis: Hemogram: Hb 14.9g/dL; VCM 106 fL; VitB12 120*pg/ml; Folic 6.12 ng/mL; IgA 479 mg/dL; Anti-transglutaminase 1.5 U7mL. Physical examination: oral thrush, restless. Second analysis: Hb 10.8 g/dL, VCM 116 fL, VitB12 147.00*pg/ml.

Method and results

The case was addressed as a vitamin b12 deficiency due to diet (strict vegetarian), deciding to start treatment with oral vitamin b12 and reassess in 3 months. But the patient did not attend the consultation for a year and on his return he presented a feeling of fullness, early satiety, bloating, belching, nausea, and vomiting. Analytical control detected megaloblastic anemia. Given the high suspicion of PA, he was referred to hematology to request anti-intrinsic Facto and Anti-parietal cell antibodies. We started cyanocobalamin im. The results were positive for anti-intrinsic factor antibodies. The patient improved his symptoms while the diagnosis was confirmed.

Conclusion

PA is the most common cause of megaloblastic anemia in our surroundings. Its incidence increases with age and is rare in people under 30 years of age. Treatment with intramuscular cyanocobalamin is for life. It is related to an increase in the incidence of gastric neoplasms, and the general practitioner must search to avoid complications.