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A female with asymptomatic primary biliary cirrhosis associated with pernicious anemia
Author(s) -
Takahashi Toru,
Honma Terasu,
Ishizuka Kisei,
Fuse Ichiro,
Asakura Hitoshi
Publication year - 2001
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2001.02572.x
Subject(s) - macrocytic anemia , medicine , pernicious anemia , primary biliary cirrhosis , gastroenterology , asymptomatic , vitamin b12 , atrophic gastritis , anemia , cirrhosis , pathology , immunology , gastritis , stomach
Abstract We experienced a female case with asymptomatic primary biliary cirrhosis that was associated with pernicious anemia after 16 years from the onset. She was 52 years old when she first visited a clinic in 1981 for liver dysfunction treatment. Antimitochondrial antibody was negative and antipyruvate dehydrogenase complex antibody was positive in a low titer in its immunoglobulin (Ig)M type. Histological examination of her liver revealed a presence of definite chronic non‐suppurative destructive cholangitis with numerous epithelioid cell granuloma. She had been given 600 mg of the oral daily dose of ursodeoxycholic acid since 1992. Macrocytic anemia incidiously appeared in September 1999. An immunological examination detected negative antiparietal cell antibodies and positive anti‐intrinsic factor antibodies. Her bone marrow smear showed numerous megaloblasts and serum vitamin B 12 in her blood was low at 99 pg/mL. Severe reversed atrophic‐type gastritis (type A gastritis) was demonstrated by the use of dye‐endoscopy with Congo red. Her macrocytic anemia dramatically improved after intramuscular administration of vitamin B 12 . In conclusion, attention should be given to the association of pernicious anemia during the follow up of primary biliary cirrhosis.