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Abstract
Background
Pernicious anemia is the most common cause of vitamin B12 deficiency in western populations, but to date, only case reports or small series dealing with this malady have been reported in Korea. This study describes the clinical characteristics of pernicious anemia in Koreans.
Methods
We retrospectively analyzed the clinical data for twenty-two Korean patients with pernicious anemia who were diagnosed during the period from 1995 to 2004 at Chungnam National University Hospital.
Results
Only two patients were diagnosed before 2000. The median age of the patients was 66 years and the male/female ratio was 1.8. Anemia-associated discomfort was the most common symptom (95.5%); this was followed by gastrointestinal and neurological symptoms (77.2% and 50.0%, respectively). Autoimmune disorders were found in five patients (22.7%). The median hemoglobin level was 7.0g/dL (range: 3.1～11.8g/dL) and pancytopenia was found in 12 patients (54.5%). The median serum vitamin B12 Level was 26pg/mL (range: 12～189pg/mL). Fifteen (78.9%) and eight (42.1%) of the 19 patients who underwent tests for antibodies were positive for anti-intrinsic factor and anti-parietal cell antibody, respectively. Nineteen of 21 patients who were treated with intramuscular cobalamin recovered from their cytopenia within 3 months. The gastrointestinal symptoms resolved completely for all the patients, while neurological symptoms remained for some of the patients.
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Fig. 1.
Annual distribution of the numbers of newly diagnosed patients with megaloblastic anemia associated with cobalamin deficiency.
Table 1.
Causes of vitamin B12 deficiency in megaloblastic anemia (n=58)
| Causes | No. of patients (%) |
|---|---|
| Pernicious anemia | 22 (37.9) |
| Gastrectomy | 27 (46.6) |
| Others | 9 (15.5) |
Table 2.
Patient characteristics (n=22)
Table 3.
Symptoms and signs (n=22)
Table 4.
Laboratory findings at the time of diagnosis
Table 5.
Gastroscopic and histologic findings
Table 6.
Responses to cobalamin therapy (n=21)
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