The Power Course

Anemia with paraesthesia


A 50-year-old man presents with paraesthesia, HB 6.8gram/dl. Peripheral smear shows macrocytosis and neutrophils with hyperpigmented nuclei. Endoscopy reveals atrophic gastritis. Which of the following deficiency is more likely


1 ) Folate deficiency
2 ) Vitamin B12 deficiency
3 ) Riboflavin deficiency
4 ) None of the above


Pernicious Anemia.

Pernicious anemia is megaloblastic anemia due to a deficit in an intrinsic factor. The intrinsic factor is is a glycoprotein that helps in the absorption of vitamin B12 at the terminal ileum. 

Pernoceous anemina is autoimune disease. Auto antibodies are against gatric mucosal pariatal cells and intrensic fatcor.

Symptoms are fatigue, pallor, paresthesia, incontinence, psychosis, and generalized weakness.

Clinical manifestations
Hematological manifestations:

pallor, fatigue, shortness of breath, dizziness, tachycardia, lightheadedness, and decreased cognitive and physical function

Gastrointestinal manifestations:

abdominal bloating, loss of appetite, weight loss, and diarrhea 


Neurological manifestations:

Peripheral neuropathy, paresthesia, weakness, ataxia, forgetfulness, and psychosis.


Parentral supplementation of vitamin B12.



Vitamin B12 deficiency

Last Modified : 18-Jan-2020

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