title: Coexistence of megaloblastic anemia and iron deficiency anemia in a young woman with chronic lymphocytic thyroiditis.
abstract: Pernicious anemia is a megaloblastic anemia caused by vitamin B12 deficiency, and is the end-stage of autoimmune gastritis that typically affects persons older than 60 years. It is the most common cause of vitamin B12 deficiency. Pernicious anemia can also be diagnosed concurrently with other autoimmune diseases. We report the occurrence of megaloblastic anemia in a 22-year-old woman with chronic autoimmune thyroiditis for 10.5 years. Recently, she presented with microcytic anemia, and iron deficiency anemia was diagnosed initially. After administration of ferrous sulfate, macrocytic anemia was revealed and vitamin B12 deficiency was detected. Pernicious anemia was highly suspected because of the endoscopic finding of atrophic gastritis, and high titer of antigastric parietal cell antibody, as well as elevated serum gastrin level. After intramuscular injections of hydroxycobalamine 100 microg daily for 10 days, and monthly later, her blood counts returned to normal.
authors.affiliation: Division of Pediatric Hematology/Oncology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Chang Gung Children's Hospital, Taoyuan, Taiwan.
authors.forename: Shih-Hsiang
authors.initials: SH
authors.lastname: Chen
authors.forename: Chia-Sui
authors.initials: CS
authors.lastname: Hung
authors.forename: Chao-Ping
authors.initials: CP
authors.lastname: Yang
authors.forename: Fu-Sung
authors.initials: FS
authors.lastname: Lo
authors.forename: Hsun-Hui
authors.initials: HH
authors.lastname: Hsu
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000752:Anemia, Pernicious / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D005296:Ferrous Compounds / Q000008:administration & dosage*; D005757:Gastritis, Atrophic / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D050031:Hashimoto Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D006879:Hydroxocobalamin / Q000008:administration & dosage*; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
chemical_list: D005296:Ferrous Compounds; D006397:Hematinics; C020748:ferrous sulfate; D006879:Hydroxocobalamin