Pernicious Anemia: Definition, Pathophysiology, Symptoms, Treatment and MCQs for NEET, GPAT, CSIR NET JRF

Pernicious Anemia: Definition, Pathophysiology, Symptoms, Treatment and MCQs for NEET, GPAT, CSIR NET JRF

“Pernicious anaemia is a chronic disorder of middle – aged and elderly individuals of either sex in which intrinsic factor (IF) secretion ceases owing to atrophy of the gastric mucosa.”

1.] Pernicious anemia is first described by Addison in 1855.

2.] Pernicious anemia is also called Addisonian megaloblastic anemia.

PATHOGENESIS: –

Certain evidence suggests that low level of IF is caused by an autoimmune reaction against gastric parietal cells is due to the atrophy of gastric mucosa in pernicious anemia.

Evidences which support the immunological abnormalities of Pernicious anemia are as follows: –

    • The incidence of pernicious anemia is high in patients with other autoimmune disease such as Grave’s disease, myxoedema, thyroiditis and idiopathic adrenocortical insufficiency.
    • Patients having pernicious anaemia have abnormal circulating autoantibodies.
    • Relatives of patients with pernicious anaemia have an increased incidence of the disease.
    • PA is more commonly seen in patients with agammaglobulinemia supporting the role of cellular immune system in destruction of the parietal cell.

SYMPTOMS: –

Following are the symptoms of Pernicious Anemia:

  • Weakness
  • Fatigue
  • Lack of Hemoglobin
  • Pale skin due to anemia
  • Weight loss
  • Headache due to the deficiency of Oxygen carrying molecule hemoglobin
  • Chest pain

TREATMENT: –

Patients having pernicious anaemia are treated with Vitamin B-12 in the following ways:

  • Parenteral vitamin B-12 replacement therapy.
  • Symptomatic and supportive therapy such as physiotherapy for neurologic deficits and occasionally blood transfusion.
  • Follow-up for early detection of cancer of the stomach.

Following are the medication given to the patient having megaloblastic anaemia:

  • Iron slats like Ferrous sulfate, Ferrous gluconate, Ferrous fumarate.

MULTIPLE CHOICE QUESTIONS: –

1.] Megaloblastic anaemia can be caused by?

a. Tapeworm infestation

b. Gastric reactions

c. Nutritional deficiency

d. All of the above

2.] The condition associated with increased demand of Vitamin B-12?

a. Splenectomy

b. Hypothyroidism

c. Pregnancy

d. Aplastic anaemia

3.] Consequences of Vitamin B-12 deficiency is impaired?

a. DNA synthesis

b. Absorption of iron

c. Folic acid synthesis

d. Production of intrinsic factor

4.] Vitamin B-12 – IF complex is absorbed in?

a. First part of duodenum

b. Ileum

c. Jejunum

d. Second part of duodenum

5.] The following does not cause Vitamin B-12 deficiency?

a. Pernicious anaemia

b. Fish tapeworm infestation

c. Ileal resection

d. Colectomy

6.] The intrinsic factor is required for the absorption of?

a. Iron

b. Zinc

c. Magnesium

d. Vitamin B-12

7.] Deficiency of intrinsic factor may be caused by?

a. Gastrectomy

b. Large bowel resection

c. Crohn’s disease

d. None of the above

8.] The peripheral blood smear in megaloblastic anaemia show following feature except?

a. Howel-Jolly bodies

b. Macroovalocytes

c. Increased reticulocytes

d. Hyper segmented neutrophils

9.] Which of the following anaemia is caused by Vitamin B-12 deficiency?

a. Haemolytic anaemia

b. Pernicious anaemia

c. Only (a)

d. None of the above

10.] Following are the laboratory findings of megaloblastic anaemia except?

a. Increased no. of platelets

b. Increased precursor in bone marrow

c. Only (b)

d. None of the above

 

SOLUTIONS: –

1.] (d)

2.] (c) Pregnancy

3.] (a) DNA synthesis

4.] (b) Ileum

5.] (b) Fish tapeworm infestation

6.] (d) Vitamin B-12

7.] (a) Gastrectomy

8.] (c) Increased reticulocytes

9.] (b) Pernicious anemia

10.] (a) Increased no. of platelets

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REFERENCES: –

1.] Textbook of Pathology by Harsh Mohan; 7th edition; Page no.285 – 286.

2.] Robbin’s Basic Pathology; 5th edition; Page no.607 – 608.

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