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Pernicious Anemia

Pernicious Anemia 

Clinical and laboratory Findings 



1- Neurological manifestations in the form of peripheral neuropathy with degeneration of the spinal cord 
2- Complete blood count (CBC).
( Hb concentration , RBCs count and PCV are reduced ) 
Increased MCV and MCH with normal MCHC ( Macrocytic  normochromic anemia )
3 - Blood film shows macrocytes  with fully hemoglobinization , Anisocytosis , Poikylocytosis 
4 - Shift to right , ( the neurophils  are hypersgmented ) 
5 - Pancytopenia
6 - Howell jolly bodies are present . 
7 - Bone marrow characterized by the presence of large megaloblastic erythroid cells and large giant metaamyelocytes and hypersegmented neutrophils . ALSO M/E ratio is reduced 
8 - Serum B12 level is decreased 
9 - Increased Urinary excration of methylmalonat . 
10 - Presence of internsic factor and parietal cell antibodies in serum and in gastric juice

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