Pernicious Anemia

Pernicious Anemia

Introduction

Pernicious anemia is produced by the abnormal red blood cells due to the lack of ability to take up vitamin B12. Particularly the reason for this type of anemia is the actual atrophic cells disorder, which causes an interior lacking of the capability of absorbing vitamin B12. For this reason, it is also known as “Vitamin B12 Deficiency Anemia”. This vitamin executes an imperative responsibility in the maturity and development of the red cells of blood. They contain significant amounts in the liver, dairy products, beans, pulp and meat.

This anemia occurs as a result of chronic inflammatory processes of various organs (lung, kidney, liver), caused by infectious agents in systemic connective tissue disease, endocrine disease and with tumors of different locations. The etiology of anemia of chronic disease include the infections (acute and chronic), virus like HIV, bacterial, parasitic, fungal, and tumor, hemoblastoses, solid tumors, autoimmune diseases like rheumatoid arthritis, systemic lupus erythematosus and other connective tissue disease, vasculitis, sarcoidosis, chronic inflammatory bowel disease, chronic graft rejection, and chronic kidney disease.

Discussion

Case Scenario

Jannie Jones was an African American female who was being admitted to Mercy Hospital with the complaint of de-hydration, along with the objective findings of disorientation, vomiting, 101degree Faranheit, and a blood pressure of 90/50 mmHg. Her subjective findings were thirst, polydipsia (lack of urination), nausea. Her general examination included 64 inches height, 105lbs body weight which was around 135 lbs 3 months before. There is nearly 22% change in her body weight. She had a medical history of hypercholesterolemia and hypertension. On social assessment, it became evident that she was living alone, and not able to go for shoping without assistance of her neighbor, and had a lack of appetite. Her physical symptoms took in extended thyroid, pale eyes, dull hairs, red tongue, dry and scaly skin, hypogeusia (poor sense of taste), and inappropriately fitted dental. Pathogenesis

As per case of Jannie Jones, the pathogenesis of pernicious anemia, most often takes place a combination of several factors leading to anemia (1) the life of red blood cells get slightly reduced, (2) there is sequestration of iron in the cells of the reticuloendothelial system, which cannot be effectively utilized by the body (but can be blocked by the transition of iron of the reticuloendothelial cells in bone marrow erythroblasts) (3) a high enough level of erythropoietin (erythropoiesis inhibition) relative to the degree of anemia (Hoffbrand,2011).

Causes

Genetic

Abnormalities of cell membrane of red cells of blood: elliptocytosis, inherited spherocytosis

Aberrations of haemoglobin: thalassaemia, sickle cell anaemia

Defects of enzyme: pyruvate kinase deficiency, glucose-6-phosphate dehydrogenase

Acquired

Immune:

Iso-immune: haemolytic sickness of infant, reaction of transfusion of blood

Autoimmune:

Temperate type of antibody: “idio-pathic”, “systemic lupus erythematosus”, “lymphoma”, “chronic lymphatic leukaemia (CLL)”, “Evans' syndrome (thrombocytopenia associated with a helpful undeviating Coombs test)”

Frozen type of antibody: “icy disease of haemagglutinin”, “paroxysmal frozen haemoglobinuria”, “mycoplasma pneumonia”, “lymphoma”, “infectious mononucleosis” or other infections of virus

Associated with drug related: medicine attracted on surface of red cell,for example “penicillin”, “cephalosporins”, or “immune complex mediated”, such as sulphonamides

Non-immune: distress (microangiopathic anaemia, cardiac ...