A female of 55 years visits a doctor with history
of intermittent soreness of tongue and diarrahoea associated with fatigue,
breathlessness, anorexia, pins and needles sensation. On clinical examination,
the skin and mucous membrane are pale, the tongue is red and ulcerated. Spleen
is not palpable.
Investigations:
- Histamine fast achlorrhydria
- RBC count: 1 million / cu.mm of blood.
- RBC: Irregular in size and shape with nucleated RBCs.
- Leucopenia, Thrombocytopenia.
Q1. What type of anaemia does this patient have?
Q2. What is the most possible cause of the anaemia in this
patient?
Q3. What are the principles involved in the treatment?
A1. It is Pernicious Anaemia.
A2. Cause: Vitamin B12 deficiency.
A3. Principles: Intramuscular injection of vitamin B12, but
not orally because there is no Intrinsic factor for vitamin B12
absorption.