No abstract available.
Anemia, Pernicious* ; Osteoporosis*

No abstract available.
Anemia, Megaloblastic ; Anemia, Pernicious* ; Vitamin B 12

No abstract available.
Anemia, Pernicious ; Humans ; Vitamin B 12 ; Vitamins

Two cases of juvenile pernicious anemia in Korean sisters have been followed for 4 years since 7 years and 4 years of age respectively. The symptoms and signs were pale facies, general malaise, sore tongue, anorexia, frequent febrile episodes, macrocytic hyperchromic anemia, thrombocytopenia, multilobulated leucocytes with more than 6 lobules and megaloblastic proliferation in bone marrow aspiration. Dramatic hematological response to the parenteral administration of vitamin B12 with a significantly increased excretion rate of vitamin Bl2 by Schilling test as shown by an increase from 0 to 11.6% in elder sister and from 0 to 5.6% in younger sister with the addition of commercial intrinsic factor were demonstrated. These findings are compatible with the characteristics of juvenile pernicious anemia resulting from defect of Cast1e's intrinsic factor.
Anemia, Pernicious/*genetics ; Child ; Female ; Human ; Vitamin B 12/*therapeutic use

Increased risk of gastric cancer has been reported in patients with chronic atrophic gastritis that develops in conjunction with pernicious anemia. We report here a case of a gastric adenocarcinoma associated with pernicious anemia. A 40-year-old female patient had been diagnosed with anemia 6 years earlier at a local hospital. One month ago, she visited our hospital for aggravated dizziness and newly developed epigastric soreness. Her blood hemoglobin level was 4.2 g/dl, and a gastroscopic work-up for anemia discovered a 2.5-cm-sized, slightly elevated mucosal lesion at the anterior wall of the high body in the stomach. The biopsy of this lesion revealed a moderately-differentiated adenocarcinoma. She underwent a total gastrectomy with a Roux en Y esophagojejunostomy with D2 lymph node dissection. The final stage of the gastric carcinoma was identified as T1N0M0. Based on this experience, we recommend that a follow-up gastroscopy be performed in patients with pernicious anemia with atrophic gastritis because of the increased risk of gastric cancer in patients with pernicious anemia.
Adenocarcinoma* ; Adult ; Anemia ; Anemia, Pernicious* ; Biopsy ; Dizziness ; Female ; Gastrectomy ; Gastritis, Atrophic ; Gastroscopy ; Humans ; Lymph Node Excision ; Stomach ; Stomach Neoplasms

Pernicious anemia is caused by the absence of intrinsic factor from autoimmune destruction of parietal cells. Patients with pernicious anemia are predisposed to the development of gastric cancer. We report here a case of pernicious anemia with early gastric cancer. A 65 year old woman was presented with severe anemia and glossitis. Her serum cobalamin level was low, and serologic test to anti-intrinsic factor antibody and anti-parietal cell antibody were positive. Gastroscopic examination revealed an early gastric cancer and type A atrophic gastritis. This patient underwent radical subtotal gastrectomy and received daily oral vitamin B12 replacement.
Aged ; Anemia ; Anemia, Pernicious* ; Female ; Gastrectomy ; Gastritis, Atrophic ; Glossitis ; Humans ; Intrinsic Factor ; Rabeprazole ; Serologic Tests ; Stomach Neoplasms* ; Vitamin B 12

BACKGROUND: The traditional treatment of cobalamin deficiency anemia is performed by intramuscular injections. However, it has been suggested that oral replacement of cobalamin is also effective as an intramuscular injection. We studied the effectiveness of oral mecobalamin treatment in patients with cobalamin deficiency. METHODS: Patients with newly diagnosed cobalamin deficiency (<200 pg/mL) or who were previously maintained on intramuscular injection were given 2,000 microgram of oral mecobalamin daily. RESULTS: Sixteen patients were enrolled. The common causes of cobalamin deficiency were total gastrectomy (75%) and pernicious anemia (12.5%). Twelve patients received oral mecobalamin, except for four patients who were lost from follow-up after initial diagnosis. The mean pretreatment values of serum cobalamin and hemoglobin level were 58.3+/-21.9pg/mL and 8.1+/-1.9g/dL, respectively. After one, two, and six months of oral therapy, the respective mean values were 1,691.8+/-260.4pg/mL, 1,085.8+/-1,110.3pg/mL and 990.2+/-249.8pg/mL of serum cobalamin, and 10.4+/-1.3g/dL, 11.3+/-2.2g/dL and 12.1+/-2.3g/dL of hemoglobin. Initially elevated serum homocysteine were normalized after one month of oral therapy. Symptoms such as glossitis were relieved rapidly by oral treatment. CONCLUSION: High-dose oral mecobalamin supplement was a simple and effective treatment in patients with cobalamin deficiency, especially in total gastrectomized patients.
Anemia ; Anemia, Pernicious ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Glossitis ; Homocysteine ; Humans ; Injections, Intramuscular ; Vitamin B 12 Deficiency ; Vitamin B 12*

Iron deficiency anemia (IDA) and megaloblastic anemia due to vitamin B12 deficiency are well-characterized prototypes of anemia. There is no doubt that IDA is the most common hematologic disorder in Korea and worldwide as well. The diagnosis and treatment of IDA is not a difficult practice usually, however, a caution is required in detecting early-stage iron deficiency and in distinguishing IDA from anemia of chronic disorders such as chronic inflammatory disease, malignancies, chronic liver disease, and chronic renal disease. Administration of a standard iron preparation at a proper dosage over an adequate period is a prerequisite for the successful treatment of IDA, which is sometimes overlooked by both physicians and patients. Early detection and treatment as well as prevention of iron deficiency per se are also required. Pernicious anemia is the most common cause of vitamin B12 deficiency in Western populations. By contrast, the disorder is rare in Korea, although the number of cases seems to be increasing these days. The majority of patients with megaloblastic anemia reveal a history of gastrectomy. Thus, it should be reminded that vitamin B12 supplementation is important to prevent the development of overt deficiency or anemia in these susceptible individuals, since a delay in the treatment of vitamin B12 deficiency may result in an irreversible neurologic deficit.
Anemia* ; Anemia, Iron-Deficiency ; Anemia, Megaloblastic ; Anemia, Pernicious ; Diagnosis ; Gastrectomy ; Humans ; Iron ; Korea ; Liver Diseases ; Neurologic Manifestations ; Renal Insufficiency, Chronic ; Vitamin B 12 ; Vitamin B 12 Deficiency

BACKGROUND: Vitamim B12 deficinecy is not a common disease and the causes and clinical findings were not clearly documented in Korea so far. Concerning that vitamin B12 deficiency caused by gastrectomy is not uncommon, we analysized the causes of vitamin B12 deficiency and clinical findings. METHODS: We reviewed the clinical records of cases diagnosed as vitamine B12 deficiency megaloblastic anemia in Hallym Medical Center from July, 1992 to Octorber, 2004. RESULTS: Forty five cases were included. Twenty five cases were performed gastrectomy and 8 cases had pernicious anemia, however the causes of 10 cases with vitamin B12 deficiency were not clear. The rate of the cases induced by gastrectomy were increased after 2001 compared with the rate before this point. Six cases were combined with iron deficient anemia. In five of the 6 cases who were combined with iron deficient anemia, the MCV and MCH were not increased. Forty three cases had anemia and anemia-associated symptoms such as dyspnea and weakness. Some of the cases complained diarrhea, numbness, or ataxia. CONCLUSION: We found that the gastrectomy was the dominant cause of vitamin B12 deficient megaloblastic anemia in this study. We suggest that vitamin B12 deficient megaloblastic anemia should be considered in follow-up of the cases of gastrectomy.
Anemia ; Anemia, Megaloblastic* ; Anemia, Pernicious ; Ataxia ; Diarrhea ; Dyspnea ; Follow-Up Studies ; Gastrectomy ; Hypesthesia ; Iron ; Korea ; Megaloblasts* ; Vitamin B 12 ; Vitamin B 12 Deficiency ; Vitamins*

Vitiligo has been associated with various disorders including thyroid disease, type I diabetes, alopecia areatal and pernicious anemia. It has been purported to be caused by autoimmune response. Vitiligo and alopecia areata occurring in the same patient has often been found, but colocalization of these two diseases has been rarely reported. It is suggested that this concurrence can result from a nonspecific immune mechanism affecting not only the melanocyte but the epithelium of the hair follicle as well. Thus colocalization can occur due to costimulation of a helper T-cell-mediated immunologic response or through inactivation of a suppressor-mediated response and other composite mechanisms such as neurogenic factors, stress and infection. We report a 17-year-old Korean female who presented with a 1-year history of alopecia and depigmentation on the same site of the left eyebrow. We diagnosed this skin lesion as colocalization of vitiligo and alopecia areata by both clinical and histopathological findings.
Adolescent ; Alopecia Areata* ; Alopecia* ; Anemia, Pernicious ; Autoimmunity ; Epithelium ; Eyebrows ; Female ; Hair Follicle ; Humans ; Melanocytes ; Skin ; Thyroid Diseases ; Vitiligo*