[Update of pernicious anemia. A retrospective study of 49 cases].
OBJECTIVE
The aim of this study was to describe the present clinical characteristics of the pernicious anemia (PA).


METHODS
It is a retrospective (1996-2002) multicenter (five departments of internal medicine) study of 49 patients presenting an established cobalamin deficiency related to PA.


RESULTS
The median age of the patients was 74 years (25-93), the female/male ratio 2:9. Several autoimmune disorders were noted in 35% of the patients. Various clinical manifestations, mainly neurological, cutaneous and thrombotic, were found in 65.4% of the patients, at least one hematological abnormalities in 100%. Average serum vitamin B12 and homocystein levels were with 73 pg/ml (20-1960) and 42.9 micromol/l (7, 8-124). Anti-intrinsic factor or anti-parietal gastric cells antibodies were found in 87.5% and 62% of the patients (at least one antibody, in 96%) abnormal Schilling's test results in 86%. All the followed patients were successful treated with intramuscular (n = 27) or oral crystalline cyanocobalamin (n = 5).


CONCLUSIONS
PA was associated with several autoimmune disorders; PA may be responsible of various clinical manifestations or biological abnormalities; and oral crystalline cyanocobalamin treatment may be successful.
Service de médecine interne, diabète et maladies métaboliques de la clinique médicale B, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg, France.
N H
NH
Loukili
E
E
Noel
G
G
Blaison
B
B
Goichot
G
G
Kaltenbach
M
M
Rondeau
E
E
Andrès
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000752:Anemia, Pernicious / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D001327:Autoimmune Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012546:Schilling Test; D012737:Sex Factors; D014805:Vitamin B 12 / Q000627:therapeutic use*
D014805:Vitamin B 12