Saturday, 25 September 2010

MRCP revision battle 20.5: Pernicious anaemia

Pernicious anaemia is an autoimmune atrophic gastritis which leads to achlorhydria and lack of intrinsic factor.

It affects 1:1000 and is commonest in blood group A

Diagnosis may be by:
  • parietal cell antibodies - present in 90% of patients with PA - but also 3-10% of people without
  • intrinsic factor antibodies - less common but more specific
  • the schilling test - click here if it wasn't drummed into you ad nauseum at med school!

Treatment of pernicious anaemia is by B12 injections.

Note gastric cancer is 3x more common in people with PA.

Now for some diversification into the exciting area of small to medium vessel vasculitis...