What are symptoms of pernicious anemia
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Symptoms of Pernicious Anemia
Pernicious anemia (PA) is a condition resulting from vitamin B12 deficiency due to impaired absorption, often linked to autoimmune gastritis. This article synthesizes the clinical features and symptoms associated with pernicious anemia, drawing from multiple research studies.
Anemia-Associated Symptoms
Fatigue and Weakness
Fatigue is a prevalent symptom of pernicious anemia, often accompanied by general weakness and lightheadedness 123. Patients may also experience pallor, which can sometimes be masked by a lemon-yellow tinge to the skin .
Tachycardia and Pallor
Tachycardia, or an increased heart rate, is another common symptom, along with noticeable pallor, although the latter can sometimes be less apparent due to the skin's yellowish hue 26.
Gastrointestinal Symptoms
Gastrointestinal Discomfort
Gastrointestinal symptoms are frequently reported, including discomfort and dyspepsia. These symptoms often resolve completely with vitamin B12 supplementation 19.
Neurological Symptoms
Peripheral Neuropathy
Neurological symptoms are significant in pernicious anemia and include peripheral numbness, paresthesias (tingling sensations), and eventual weakness and ataxia (loss of coordination) 25. These symptoms can persist even after treatment in some cases .
Cognitive and Psychiatric Symptoms
Cognitive impairments such as memory loss, poor concentration, and psychiatric symptoms like depression, mania, and psychosis are also associated with pernicious anemia. In some cases, psychiatric symptoms may precede hematological and neurological abnormalities 3410.
Severe Neurological Manifestations
In severe cases, patients may experience more profound neurological issues such as ambulatory dysfunction, characterized by progressive lower extremity weakness and ataxia . Additionally, symptoms like cephalalgia (headache), vertigo, syncope (fainting), and mental disturbances have been documented .
Hematologic Manifestations
Pancytopenia and Hemolysis
Pancytopenia, a reduction in the number of red and white blood cells and platelets, is observed in some patients . Hemolysis, although rare, can occur and may present as pseudothrombotic microangiopathy (pseudo-TMA), characterized by hemolytic anemia, thrombocytopenia, and schistocytosis .
Autoimmune Associations
Autoimmune Disorders
Pernicious anemia is often associated with other autoimmune disorders, such as autoimmune thyroid disease and diabetes mellitus, as part of the autoimmune polyendocrine syndrome 19.
Conclusion
Pernicious anemia presents with a wide array of symptoms, primarily due to vitamin B12 deficiency. These include fatigue, gastrointestinal discomfort, neurological impairments, and cognitive and psychiatric disturbances. Early recognition and treatment with vitamin B12 supplementation are crucial to managing these symptoms and preventing irreversible damage.
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