Premium
Do all the patients with vitamin B12 deficiency have pernicious anemia?
Author(s) -
Sun Andy,
Chang Julia Y.F.,
Wang YiPing,
Cheng ShihJung,
Chen HsinMing,
Chiang ChunPin
Publication year - 2016
Publication title -
journal of oral pathology and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.887
H-Index - 83
eISSN - 1600-0714
pISSN - 0904-2512
DOI - 10.1111/jop.12330
Subject(s) - vitamin b12 , mean corpuscular volume , medicine , homocysteine , pernicious anemia , anemia , hemoglobin , iron deficiency , endocrinology , cobalamin , vitamin d deficiency , atrophic gastritis , gastroenterology , vitamin d and neurology , gastritis , stomach
Background Vitamin B12 deficiency may result in pernicious anemia ( PA ). This study evaluated whether all the patients with vitamin B12 deficiency had PA . Methods The blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine concentrations and mean corpuscular volume ( MCV ) in 90 vitamin B12‐deficient patients were measured and compared with the corresponding data in 180 age‐ and sex‐matched healthy control subjects. PA was defined by World Health Organization ( WHO ) as having an Hb concentration <13 g/dl for men and <12 g/dl for women, an MCV ≧ 100 fl, a serum vitamin B12 level <200 pg/ml, and serum gastric parietal cell antibody ( GPCA ) positivity. Results We found that 35 (38.9%) and 20 (22.2%) patients with vitamin B12 deficiency had deficiencies of Hb (men <13 g/dl, women <12 g/dl) and iron (<60 μg/dl), respectively. Moreover, 65 (72.2%) and 37 (41.1%) patients with vitamin B12 deficiency had abnormally high blood homocysteine level (>12.7 μM) and high MCV (≧100 fl), respectively. In addition, 43 (47.8%) vitamin B12‐deficient patients with had GPCA positivity. Patients with vitamin B12 deficiency had a significantly higher frequency of Hb or iron deficiency, of abnormally elevated blood homocysteine level or high MCV , and of GPCA positivity than healthy control subjects (all P ‐values < 0.001). However, only 17 (18.9%) of 90 vitamin B12‐deficient patients were diagnosed as having PA by the WHO definition. Conclusion Only 18.9% of patients with vitamin B12 deficiency are discovered to have PA by the WHO definition.