title: Autoimmune pernicious anaemia as a cause of collapse, heart failure and marked panyctopaenia in a young patient.
abstract: A 35-year-old woman with a history of vitiligo, hypothyroidism and amenorrhoea presented with collapse and clinical features of cardiac failure. Laboratory investigations revealed pancytopaenia, the cause of which was found to be vitamin B12 deficiency due to pernicious anaemia. Treatment with intramuscular hydroxycobalamin was commenced and the patient improved steadily with concomitant improvement in her haematological indices. Clinical features of pernicious anaemia which can include marked pancytopaenia, diagnostic approach, associated conditions and approach to treatment are discussed. The importance of surveillance for gastrointestinal malignancy is emphasised.
authors.affiliation: Department of Infectious Diseases, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia. drjustincarey@gmail.com
authors.forename: Justin
authors.initials: J
authors.lastname: Carey
authors.forename: Ebru
authors.initials: E
authors.lastname: Hack
mesh_terms: D000328:Adult; D000752:Anemia, Pernicious / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D001327:Autoimmune Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D006879:Hydroxocobalamin / Q000627:therapeutic use; D010198:Pancytopenia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D006879:Hydroxocobalamin