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pernicious anemia

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https://www.readbyqxmd.com/read/27815809/prevalence-of-thoracic-spine-lesions-masquerading-as-cauda-equina-syndrome-yield-of-a-novel-magnetic-resonance-imaging-protocol
#1
Katherine Stolper, James Clark Haug, Chad Todd Christensen, Kathleen Michelle Samsey, Michael David April
Our objective was to describe the yield of actionable thoracic spine lesions for a novel magnetic resonance imaging (MRI) protocol including evaluation of the thoracic spine among patients presenting to the Emergency Department (ED) with symptoms consistent with epidural compression syndrome. Our ED and Department of Radiology together designed a novel rapid MRI protocol entailing 3D volumetric T2 weighted sequences through both the thoracic and lumbar spine obtained in the sagittal plane to assess for both lumbar and thoracic spine lesions...
November 4, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27802920/anemia-and-hematinic-deficiencies-in-gastric-parietal-cell-antibody-positive-and-antibody-negative-erosive-oral-lichen-planus-patients-with-thyroid-antibody-positivity
#2
Julia Y-F Chang, I-Chang Chen, Yi-Ping Wang, Yu-Hsueh Wu, Hsin-Ming Chen, Andy Sun
BACKGROUND/PURPOSE: Serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) are found in some erosive oral lichen planus (EOLP) patients. This study assessed whether serum GPCA, TGA and TMA and EOLP itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive EOLP patients with GPCA positivity (GPCA(+)/TGA/TMA/EOLP patients) or negativity (GPCA(-)/TGA/TMA/EOLP patients). METHODS: The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of the four groups of 29 GPCA(+)/TGA/TMA/EOLP patients, 80 GPCA(-)/TGA/TMA/EOLP patients, 198 all antibodies-negative EOLP patients (Abs(-)/EOLP patients), and 218 healthy control individuals...
November 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27793414/antigastric-parietal-cell-and-antithyroid-autoantibodies-in-patients-with-recurrent-aphthous-stomatitis
#3
Yang-Che Wu, Yu-Hsueh Wu, Yi-Ping Wang, Julia Yu-Fong Chang, Hsin-Ming Chen, Andy Sun
BACKGROUND/PURPOSE: Anti-gastric parietal cell antibody (GPCA), anti-thyroglobulin antibody (TGA), and anti-thyroid microsomal antibody (TMA) have not yet been reported in patients with recurrent aphthous stomatitis (RAS). This study mainly assessed the frequencies of the presence of serum GPCA, TGA, and TMA in different types of RAS patients. METHODS: Serum GPCA, TGA, and TMA levels were measured in 355 RAS patients of different subtypes and in 355 age- and sex-matched healthy control individuals...
October 25, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27765664/differentiation-of-pernicious-anemia-from-thrombotic-thrombocytopenic-purpura-the-clinical-value-of-subtle-pathologic-findings
#4
Daniel W Abbott, Kenneth D Friedman, Matthew S Karafin
BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a microangiopathic hemolytic anemia that requires emergent treatment with plasma exchange and is one of the most important conditions for which apheresis service professionals are consulted. Careful interpretation of initial laboratory values and the peripheral blood smear is a critical first step to determining the need for plasma exchange because other conditions can show deceptively similar red cell morphology, and ADAMTS13 levels are often not rapidly available...
September 28, 2016: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/27702910/reversible-facial-hyperpigmentation-associated-with-vitamin-b12-deficiency
#5
Leeda Tayem, Noureddine Litaiem, Mariem Jones, Faten Zeglaoui
Vitamin B12 (cobalamin) deficiency is common in developing countries. Its dermatologic manifestations include hair and nail changes and glossitis. Cases of generalized hyperpigmentation associated with vitamin B12 deficiency have rarely been reported. Localized hyperpigmentation is less frequently described, affecting palms, soles, and flexural areas. We report a rare case of reversible melasma-like cutaneous hyperpigmentation associated with pernicious anemia and discuss the possible mechanisms of this association...
October 4, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/27671008/autoimmune-gastritis
#6
Stefanie Kulnigg-Dabsch
Autoimmune gastritis is a chronic inflammatory disease with destruction of parietal cells of the corpus and fundus of the stomach. The known consequence is vitamin B12 deficiency and, consequently, pernicious anemia. However, loss of parietal cells reduces secretion of gastric acid which is also required for absorption of inorganic iron; thus, iron deficiency is commonly found in patients with autoimmune gastritis. This usually precedes vitamin B12 deficiency and is found mainly in young women. Patients with chronic iron deficiency, especially those refractory to oral iron therapy, should therefore be evaluated for the presence of autoimmune gastritis...
October 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27609735/a-case-of-asymptomatic-pancytopenia-with-clinical-features-of-hemolysis-as-a-presentation-of-pernicious-anemia
#7
Venkateswara K Kollipara, Patrick L Brine, David Gemmel, Sisham Ingnam
Pernicious anemia is an autoimmune disease with a variety of clinical presentations. We describe a case of pernicious anemia presenting with pancytopenia with hemolytic features. Further workup revealed very low vitamin B12 levels and elevated methylmalonic acid. It is important for a general internist to identify pernicious anemia as one of the cause of pancytopenia and hemolytic anemia to avoid extensive workup. Pernicious anemia can present strictly with hematological abnormalities without neurological problems or vice versa as in our case...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27602354/oral-vitamin-b12-replacement-for-the-treatment-of-pernicious-anemia
#8
REVIEW
Catherine Qiu Hua Chan, Lian Leng Low, Kheng Hock Lee
Many patients with pernicious anemia are treated with lifelong intramuscular (IM) vitamin B12 replacement. As early as the 1950s, there were studies suggesting that oral vitamin B12 replacement may provide adequate absorption. Nevertheless, oral vitamin B12 replacement in patients with pernicious anemia remains uncommon in clinical practice. The objective of this review is to provide an update on the effectiveness of oral vitamin B12 for the treatment of pernicious anemia, the recommended dosage, and the required frequency of laboratory test and clinical monitoring...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27599778/antigastric-parietal-cell-and-antithyroid-autoantibodies-in-patients-with-desquamative-gingivitis
#9
Julia Yu-Fong Chang, Chun-Pin Chiang, Yi-Ping Wang, Yang-Che Wu, Hsin-Ming Chen, Andy Sun
BACKGROUND: Desquamative gingivitis (DG) is principally associated with erosive oral lichen planus (EOLP), mucous membrane pemphigoid (MMP), and pemphigus vulgaris (PV). METHODS: Serum autoantibodies including antigastric parietal cell antibody (GPCA), antithyroglobulin antibody (TGA), and antithyroid microsomal antibody (TMA) were measured in 500 patients with DG, 287 EOLP without DG (EOLP/DG(-) ) patients, and 100 healthy control subjects. RESULTS: The 500 patients with DG were diagnosed as having EOLP in 455 (91%), PV in 40 (8%), and MMP in five (1%) patients...
September 7, 2016: Journal of Oral Pathology & Medicine
https://www.readbyqxmd.com/read/27559485/pernicious-anemia-with-autoimmune-hemolytic-anemia-a-case-report-and-literature-review
#10
Sri Lakshmi Hyndavi Yeruva, Raj Pal Manchandani, Patricia Oneal
Pernicious anemia is a common cause of vitamin B12 deficiency. Here, we discuss a case of a young woman who presented with severe anemia along with a history of iron deficiency anemia. After a review of her clinical presentation and laboratory data, we identified an autoimmune hemolytic anemia and a concomitant pernicious anemia. The concurrence of both these hematological diagnoses in a patient is rare.
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27538411/pathophysiology-and-laboratory-diagnosis-of-pernicious-anemia
#11
Ban-Hock Toh
Pernicious anemia is the hematologic manifestation of chronic atrophic gastritis affecting the corpus of the stomach that denudes the gastric mucosa of gastric parietal cells. Asymptomatic autoimmune gastritis, a chronic inflammatory disease of the gastric mucosa, precedes the onset of corpus atrophy by 10-20 years. The gastritis arises from activation of pathologic Th1 CD4 T cells to gastric H/K ATPase that is normally resident on gastric mucosal secretory membranes. The onset of autoimmune gastritis is marked by circulating parietal cell antibody to gastric H/K ATPase...
August 18, 2016: Immunologic Research
https://www.readbyqxmd.com/read/27531538/gastric-cancer-clinical-and-epidemiological-aspects
#12
Marino Venerito, Alexander Link, Theodoros Rokkas, Peter Malfertheiner
Gastric cancer (GC) ranks fifth for cancer incidence and second for cancer deaths. Epidemiological data showed that survivors of Hodgkin's lymphoma and patients with pernicious anemia etiologically linked to autoimmune gastritis are at increased risk of GC. Screening of patients with autoimmune thyroid disease by means of pepsinogen (PG) I and PG I/II detected autoimmune gastritis with oxyntic gastric atrophy in one of four patients and may be recommended for GC prevention purposes. The International Agency for Research on Cancer reported a positive association between consumption of processed meet and increased GC risk...
September 2016: Helicobacter
https://www.readbyqxmd.com/read/27511590/hematinic-deficiencies-and-anemia-statuses-in-antigastric-parietal-cell-antibody-positive-erosive-oral-lichen-planus-patients-with-desquamative-gingivitis
#13
Julia Yu-Fong Chang, Yi-Ping Wang, Yang-Che Wu, Yu-Hsueh Wu, Chih-Huang Tseng, Andy Sun
BACKGROUND/PURPOSE: Erosive oral lichen planus (EOLP) patients with desquamative gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA(+)/DG(+)/EOLP patients). METHODS: The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA(+)/DG(+)/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups...
October 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27504588/aire-mutations-and-autoimmune-disease
#14
Øyvind Bruserud, Bergithe E Oftedal, Anette B Wolff, Eystein S Husebye
The gene causing the severe organ-specific autoimmune disease autoimmune polyendocrine syndrome type-1 (APS-1) was identified in 1997 and named autoimmune regulator (AIRE). AIRE plays a key role in shaping central immunological tolerance by facilitating negative selection of T cells in the thymus, building the thymic microarchitecture, and inducing a specific subset of regulatory T cells. So far, about 100 mutations have been identified. Recent advances suggest that certain mutations located in the SAND and PHD1 domains exert a dominant negative effect on wild type AIRE resulting in milder seemingly common forms of autoimmune diseases, including pernicious anemia, vitiligo and autoimmune thyroid disease...
August 6, 2016: Current Opinion in Immunology
https://www.readbyqxmd.com/read/27501653/anesthetic-considerations-of-stiff-person-syndrome-a-case-report
#15
Kristi Hylan, An-Duyen Nguyen Vu, Katherine Stammen
Stiff-person syndrome (SPS) is a neurologic disorder characterized by painful involuntary episodes of severe muscle rigidity affecting the axial muscles and extremities. Although the etiology of SPS is unknown, it is suspected to involve the synthesis of γ-aminobutyric acid (GABA). Symptoms of SPS are precipitated by sudden unexpected movements, noises, and stress. Additionally, SPS has been linked with various autoimmune disorders, including diabetes mellitus, thyroid disease, pernicious anemia, and certain cancers...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27473652/vitamin-b12-deficiency-presenting-with-neurological-dysfunction-in-an-adolescent
#16
Coral M Stredny, Olivia Frosch, Samata Singhi, Elissa Furutani, Adam D Durbin, Rachael F Grace, Nicole J Ullrich
BACKGROUND: Vitamin B12 deficiency is classically encountered in the adult Caucasian population and manifests as a subacute combined degeneration in the presence or absence of macrocytic anemia. However, B12 deficiency is extremely rare in children in developed countries, and pernicious anemia is even rarer etiology of this deficiency. The clinical presentation of B12 deficiency in children is not as easily recognizable or well-characterized and may result in missed or delayed diagnosis...
September 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27356735/a-case-of-vitamin-b12-deficiency-with-involuntary-movements-and-bilateral-basal-ganglia-lesions
#17
Taisuke Kitamura, Seiji Gotoh, Hayato Takaki, Fumi Kiyuna, Sohei Yoshimura, Kenichiro Fujii
An 86-year-old woman with a one-year history of dementia was admitted to our hospital complaining of loss of appetite, hallucinations, and disturbance of consciousness. She gradually presented with chorea-like involuntary movements of the extremities. Diffusion-weighted magnetic resonance imaging (MRI) showed bilateral symmetrical hyperintense signals in the basal ganglia. The serum vitamin B12 level was below the lower detection limit of 50 pg/ml. The homocysteine level was markedly elevated at 115.8 nmol/ml...
July 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
https://www.readbyqxmd.com/read/27259856/regulatory-t-cells-control-th2-dominant-murine-autoimmune-gastritis
#18
Jessica Harakal, Claudia Rival, Hui Qiao, Kenneth S Tung
Pernicious anemia and gastric carcinoma are serious sequelae of autoimmune gastritis (AIG). Our study indicates that in adult C57BL/6-DEREG mice expressing a transgenic diphtheria toxin receptor under the Foxp3 promoter, transient regulatory T cell (Treg) depletion results in long-lasting AIG associated with both H(+)K(+)ATPase and intrinsic factor autoantibody responses. Although functional Tregs emerge over time during AIG occurrence, the effector T cells rapidly become less susceptible to Treg-mediated suppression...
July 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/27222404/prevalence-of-vitamin-b-12-deficiency-among-patients-with-thyroid-dysfunction
#19
REVIEW
Aryn B Collins, Roman Pawlak
Due to the non-specificity of symptoms and possibly severe consequences of untreated vitamin B-12 deficiency, screening is important for at-risk patients to ensure the prompt delivery of treatment. In this review, studies assessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction are evaluated to determine whether regular vitamin B-12 screening is necessary. A literature search was conducted using multiple electronic databases. Only original studies assessing the prevalence of vitamin B-12 deficiency in thyroid dysfunction that reported their findings as percentages of the sample were eligible for inclusion...
2016: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/27017730/gastric-carcinoid-type-1-in-a-patient-with-autoimmune-polyglandular-syndrome-additional-endocrinological-evaluation-required
#20
Ana Marija Vrkljan, David Grasić, Ivan Kruljac, Marko Nikolić, Jaksa Filipović-Cugura, Monika Ulamec, Ksenija Kovacić, Nenad Babić, Neven Ljubicić
Autoimmune polyglandular syndrome by definition consists of two or more endocrinological insufficiencies or two organ specific autoimmune diseases. There are no stringent criteria for endocrinological evaluation of patients with one endocrine insufficiency. However, detailed endocrinological evaluation should be undertaken in patients with two autoimmune diseases. Additionally, follow up thereafter should be a must in these patients in order to avoid the possibility of not diagnosing subsequent autoimmune diseases that can occur...
December 2015: Acta Clinica Croatica
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