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