[Venous thromboembolism and hyperhomocysteinemia as first manifestation of pernicious anemia].
OBJECTIVE
Hyperhomocysteinemia is associated to thrombosis and atherosclerosis. Vitamin B12 is among its main causes and may be due to a pernicious anemia. This study aimed to know the prevalence of this disease in patients who have venous thromboembolism and hyperhomocysteinemia.


METHODS
A total of 80 consecutive patients (55 men and 25 women; age: mean [standard deviation] 63 [15] years) with pulmonary embolism and/or venous thrombosis and elevated values of homocysteine (> 12 micromol/l) were studied.


RESULTS
Pernicious anemia was diagnosed (positive Schilling test, presence of anti-intrinsic factor antibodies and/or anti-parietal cells and fundal atrophic gastritis) in 5 patients (6.25% with range of age: 42-73 years. Only one of them had macrocytic anemia and there were no alterations in any of them in the thrombophilia study. The patients were treated with vitamin B12, administering it orally (1 mg/day) in 4 of them. The homocysteine and vitamin B12 values were normalized in every case at 6 months.


CONCLUSIONS
Although the prevalence of pernicious anemia is not elevated in patients with venous thromboembolism and hyperhomocysteinemia, its existence must be ruled out to avoid other thrombotic and neurological complications.
Fernández-Miranda
C
C
Servicio de Medicina Interna, Hospital Universitario 12 de Octubre, Madrid. cfmiranda@inicia.es
Yebra Yebra
M
M
Ribera Casado
C
C
Toledo Urgarte
T
T
Martín Mola
M
M
Gómez González
P
P
D000328:Adult; D000368:Aged; D000752:Anemia, Pernicious / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013923:Thromboembolism / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology*