21. History Of Pernicious Anemia Return to History of Medicine Home Page. History of pernicious anemia. Howto Use These Slides This presentation has been enhanced using RealAudio. http://www.medinfo.ufl.edu/other/histmed/streiff/

Return to History of Medicine Home Page History of Pernicious Anemia How to Use These Slides: This presentation has been enhanced using RealAudio. To hear the audio track you will need to install the RealPlayer available free from www.real.com . To start the program, click on the icon next to slide you wish to view. After a few moments the RealPlayer will begin the audio program at that point. You may also select any slide to view it without audio. Use the controls ( ) to move forward, backward, or return to this index. You may need to adjust the font size of your browser for optimal viewing. J.S. Combe Thomas Addison Austin Flint Flint Quote ... Survival Rate Author: Dick Streiff, M.D. Contact: Russell Fielding / rtfield@ufl.edu Version: Produced by the Office of Medical Informatics 2000 by the University of Florida Location: http://www.medinfo.ufl.edu/other/histmed/streiff/index.html Created: October 2, 2000 Modified: October 13, 2000

22. History Of Pernicious Anemia - Paul Ehrlich i Paul Ehrlich. Copyright 2000 by the University of Florida. http://www.medinfo.ufl.edu/other/histmed/streiff/slide8.html

i Paul Ehrlich

23. Health Ency.: Disease: Pernicious Anemia pernicious anemia. pernicious anemia results from a lack of intrinsic factor ingastric secretions which, in turn, causes inadequate vitamin B12 absorption. http://www.accessatlanta.com/shared/health/adam/ency/article/000569.html

SEARCH: The Web Yellow Pages HOME AJC.COM Illustrated Health Encyclopedia Important notice Ency. home Disease P Pernicious anemia Overview Symptoms Treatment Prevention Alternative names: Addison's anemia; Biermer's anemia; Macrocytic achylic anemia; Congenital pernicious anemia; Juvenile pernicious anemia; Vitamin B12 deficiency (malabsorption) Definition: A form of anemia caused by a lack of intrinsic factor , a substance needed to absorb vitamin B12 (cobalamin) from the gastrointestinal tract. Causes and Risks Intrinsic factor is a binding protein required for the absorption of vitamin B12. Pernicious anemia results from a lack of intrinsic factor in gastric secretions which, in turn, causes inadequate vitamin B12 absorption. Vitamin B12 deficiency is the result. The vitamin B12 deficiency causes a form of anemia specifically referred to as megaloblastic anemia Other causes of pernicious anemia include atrophic gastric mucosa, autoimmunity against gastric parietal cells, and autoimmunity against instrinsic factor. A lack of intrinsic factor is the most common cause of vitamin B12 deficiency. Intrinsic factor is produced by cells within the stomach. In adults, the inability to make intrinsic factor is the result of chronic gastritis or is the result of gastrectomy. The onset of the disease is slow and may span decades. Very rarely, infants and children lack the ability to produce effective intrinsic factor. This form of congenital pernicious anemia is inherited as an autosomal recessive disorder. However, most often

24. Health Ency.: Disease: Pernicious Anemia pernicious anemia. the cardiovascular system. The following symptomsmay indicate pernicious anemia shortness of breath; fatigue; http://www.accessatlanta.com/shared/health/adam/ency/article/000569sym.html

SEARCH: The Web Yellow Pages HOME AJC.COM Illustrated Health Encyclopedia Important notice Ency. home Disease P Pernicious anemia Overview Symptoms Treatment Prevention Alternative names: Addison's anemia; Biermer's anemia; Macrocytic achylic anemia; Congenital pernicious anemia; Juvenile pernicious anemia; Vitamin B12 deficiency (malabsorption) Symptoms Gradually the deficiency of vitamin B12 affects sensory and motor nerves, causing neurological effects. It is important to know that the neurological effects of vitamin B12 deficiency may present before anemia is diagnosed. The anemia also affects the gastrointestinal system and the cardiovascular system. The following symptoms may indicate pernicious anemia: shortness of breath fatigue pallor rapid heart rate ... tingling and numbness of hands and feet ( paresthesias sore mouth unsteady gait , especially in the dark tongue problems smell, impaired gums, bleeding positive Babinski's reflex loss of deep tendon reflexes personality changes ("megaloblastic madness") Signs and Tests Tests that may indicate pernicious anemia include: CBC results that show low hematocrit and hemoglobin with elevated MCV (low red blood cell count with large-sized red blood cells) CBC showing low white blood count and low platelets low reticulocyte count bone marrow examination (only needed if diagnosis is unclear) serum LDH below normal serum vitamin B-12 level Schilling test measurement of serum holotranscobalamin II This disease may also alter the results of the following tests: TIBC peripheral smear leukocyte alkaline phosphatase gastrin ... Ency. home

25. Pernicious Anemia pernicious anemia Causing great harm. There is a significant differencebetween having a deficiency anemia and having pernicious anemia. http://www.askemilyss.com/n&d/pernicious_anemia.htm

Pernicious Anemia Causing great harm December 2000 By Jori Hickman-Metcalf Anemia: A disease in which the size or shape of red blood cells is altered and the number of red blood cells is reduced. Some types of anemia are caused by deficiencies of nutrients such as vitamin B12, folic acid, or iron. Strict vegetarians are at high risk of deficiency anemia. There is a significant difference between having a deficiency anemia and having Pernicious Anemia. Pernicious Anemia is a severe autoimmune disease caused by the inability of the body to absorb vitamin B12 from the digestive tract into the bloodstream. Pernicious Anemia isn't a direct dietary problem. It results from the body's inability to produce an intrinsic factor, a protein, that is necessary for the efficient movement of vitamin B12 from the digestive tract into the bloodstream. This often occurs as an end stage of Autoimmune Gastritis, which is the destruction of gastric mucosa, moist tissue that lines the stomach or can follow surgery that removes a part of the intestinal region, colon, or stomach. The autoimmune disease slowly kills off the ability to supply this vital nutrient to organs and bone marrow, eventually attacking organs such as the liver, spleen, kidneys, heart, and the brain. Before the 1940s, this type of anemia was an invariably fatal disease. That is approximately when vitamin B12 was discovered. Today, once the problem is diagnosed, it can be controlled easily with periodic B12 injections for lifetime. The disease stays in remission as long as the injections are given.

26. Pernicious Anemia pernicious anemia. Definition. pernicious anemia is a disease in which the red bloodcells are abnormally formed, due to an inability to absorb vitamin B 12 . http://www.hendrickhealth.org/healthy/001049.htm

MAIN SEARCH INDEX Pernicious anemia Definition Description Causes and symptoms Diagnosis ... Resources Definition Pernicious anemia is a disease in which the red blood cells are abnormally formed, due to an inability to absorb vitamin B . True pernicious anemia refers specifically to a disorder of atrophied parietal cells leading to absent intrinsic factor, resulting in an inability to absorb B Description Vitamin B , or cobalamin, plays an important role in the development of red blood cells. It is found in significant quantities in liver, meats, milk and milk products, and legumes. During the course of the digestion of foods containing B , the B becomes attached to a substance called intrinsic factor. Intrinsic factor is produced by parietal cells which line the stomach. The B -intrinsic factor complex then enters the intestine, where the vitamin is absorbed into the bloodstream. In fact, B can only be absorbed when it is attached to intrinsic factor. In pernicious anemia, the parietal cells stop producing intrinsic factor. The intestine is then completely unable to absorb B . So, the vitamin passes out of the body as waste. Although the body has significant amounts of stored B

27. HealthlinkUSA Pernicious Anemia Links AhHa. pernicious anemia Products- Lowest Prices At DealTime! FindWhat. Click herefor page 1 of pernicious anemia information from the HealthlinkUSA directory. http://www.healthlinkusa.com/637ent.htm

28. Pernicious Anemia; Treatment, Prevention, Cure pernicious anemiaSearch information from many of the best pernicious anemia healthsites. pernicious anemia Message Board. Thalassemia. FASTATS Anemia. http://www.healthlinkusa.com/content/637.html

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29. September 1996 - SMJ: Gastric Cancer And Pernicious Anemia... Gastric Cancer and pernicious anemia Appearing as Pseudoachalasia. 1. Hsing AW,Hansson LE, McLaughlin JK, et al pernicious anemia and subsequent cancer. http://www.sma.org/smj/96sept13.htm

Gastric Cancer and Pernicious Anemia Appearing as Pseudoachalasia Hussein M. El-Newihi, MD, Gregory W. Dellinger, MD, Anastasios A. Mihas, MD, and James L. Achord, MD, Jackson, MS ABSTRACT: An elderly black man was admitted to our institution with macrocytic anemia, dysphagia, and significant weight loss. Results of an esophagogram were suggestive of achalasia. Gastric adenocarcinoma infiltrating the gastric cardia was seen on gastroscopy. The mode of presentation of gastric cancer in this case has not been previously reported in association with pernicious anemia. Patients with pernicious anemia are at higher risk of having gastrointestinal neoplasms than is the general population. We review the current literature and address the controversy concerning the need to subject patients with pernicious anemia to surveillance with upper gastrointestinal endoscopy. CASE REPORT Fig 1 ). The mucosa of the narrowed part was smooth, and barium entered the stomach poorly and in bursts. The possibility of achalasia of the esophagus was raised. Endoscopy of the upper GI tract showed normal esophageal mucosa and a moderately dilated esophageal lumen. The gastroesophageal junction was entered with mild resistance. A retroflexed view revealed a mass in the cardia ( Fig 2 The patient had subtotal proximal gastrectomy and distal esophagectomy with primary anastomosis and splenectomy. The tumor measured 2 cm in diameter and penetrated the gastric wall through the serosa. Ten of the 12 resected lymph nodes were involved with the neoplasm. The tumor was classified as T3, N1, M0. Subsequently, the patient received 25 sessions of external radiation delivering a total of 45 Gy, as well as 2 cycles of 5-fluorouracil and leucovorin. Within 4 months, two new masses were detected in the liver on computed tomography. The patient died of pneumonia 6 months after the initial hospital admission, with evidence of metastatic gastric adenocarcinoma.

30. Megaloblastic (Pernicious) Anemia - Lucile Packard Children's Hospital pernicious) anemia? Megaloblastic anemia, also called pernicious anemia,is a type of anemia characterized by very large red blood cells. http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/hematology/megalob.html

Bone Marrow Transplantation Hematology Hematopoietic Stem Cell Transplantation Oncology ... Oncology Megaloblastic (Pernicious) Anemia What is megaloblastic (pernicious) anemia? Megaloblastic anemia, also called pernicious anemia, is a type of anemia characterized by very large red blood cells. In addition to the cells being large, the inner contents of each cell are not completely developed. This malformation causes the bone marrow to produce fewer cells, and sometimes the cells die earlier than the 120-day life expectancy. Instead of being round or disc-shaped, the red blood cells can be oval. What causes megaloblastic (pernicious) anemia? There are many causes of megaloblastic anemia, but the most common source in children occurs from a vitamin deficiency of folic acid. Other sources of megaloblastic anemia include the following: digestive diseases Certain diseases of the lower digestive tract can lead to megaloblastic anemia. These include celiac disease, chronic infectious enteritis, and enteroenteric fistulas. malabsorption Inherited congenital folate malabsorption, a genetic problem in which infants cannot absorb folic acid in their intestines, can lead to megaloblastic anemia. This requires early intensive treatment to prevent long term problems such as mental retardation.

31. Vitamin B12 Deficiency The result is pernicious anemia (PA). 1. The term pernicious anemia is sometimesused colloquially to refer to any anemia caused by vitamin B12 deficiency. http://www.healthwell.com/healthnotes/Concern/Vitamin_B12_Deficiency.cfm

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32. Vitamin B12 Anemia Created By JackCrisp.com Oral Cobalamin for pernicious anemia. Medicine's Best Kept Secret? THE TREATMENT ofpernicious anemia with cobalamin is one of medicine's great success stories. http://www.vitab12.com/anemia.html

"Gentlemen: The 1,000mcg oral B-12, Natural Brand are making my day! Taking 3 or 4 in the morning and if needed, 2 or 3 in the afternoon. Keeps my energy level up, makes me feel great, and calms my nerves. The terrific part - its all natural B-12 crystals! Glad I found you. Thanks Again! Your grateful customer," Signed, Corinne Bosick Oral Cobalamin for Pernicious Anemia Medicine's Best Kept Secret? Department of Medicine Promising results from early studies of oral cyanocobalamin therapy led to the use of increasingly larger doses, and several groups reported complete success with doses of 300 to 1000 ug. (6,8) The largest study described 64 Swedish patients with pernicious anemia and other cobalamin deficiency states who were treated with 1000 ug of oral cyanocobalamin daily, with 61 of these patients treated for more than 3 years,. Clinical and hematologic remissions, normalization of serum levels, and full replenishment of hepatic stores were observed in all patients. (8,9) Oral therapy is currently used by 40% of patients requiring cobalamin replacement in Sweden (R. Berlin, MD, written communication, November 1989), where it has proved to be a completely safe alternative to B-12 injections. (10) In the United States, oral therapy ceased to be available in the late 1950s. Much to the regret of all hematologists and patients who had used the tablets. (1) Oral therapy became available again in this country in the early 1970's, but it is rarely prescribed. In a survey of 245 Minneapolis (Minn.) internists, none had used oral cobalamin to treat pernicious anemia, and only 1% had used it to treat dietary cobalamin deficiency.

33. Pernicious Anemia O'Reilly. pernicious anemia. Overview. · pernicious anemia (PA) isthe most common cause of vitamin B 12 deficiency. B 12 http://www.med.unc.edu/medicine/web/perniciousanemia.htm

Residents' Report August 17, 1998 Kevin P. O'Reilly Pernicious Anemia Overview Pernicious anemia (PA) is the most common cause of vitamin B deficiency. B deficiency actually has many causes however PA applies only to the condition associated with chronic atrophic gastritis. PA was first described by Addison in 1849 and associated with the stomach by Austin Flint in 1860. PA was later successfully treated with cooked liver and subsequent theories on the pathogenesis of PA involved the loss of an extrinsic factor from the liver and an intrinsic factor (IF) from the stomach. A recent population survey found that approximately 2% of persons over 60 years of age have undiagnosed PA. The disease was previously thought to occur only in those of Northern European extraction, however subsequent studies have noted PA to occur in Hispanic and African-American patients. Pathology Gross pathology – The stomach has three regions: the fundus and the body, which contain acid secreting parietal cells and pepsinogen secreting zymogen cells, and the antrum which contain gastrin secreting G-cells. Chronic atrophic gastritis is recognized grossly by the loss of gastric mucosal folds and thinning of the gastric mucosa. There are two types based on whether the lesion affects the antrum. Type A (autoimmune) Chronic Gastritis Type B (nonautoimmune) Chronic Gastritis Affects fundus and body, spares antrum

34. Pernicious Anemia pernicious anemia. Definition. pernicious anemia is a disease in which the red bloodcells are abnormally formed, due to an inability to absorb vitamin B 12 . http://www.healthatoz.com/healthatoz/Atoz/ency/pernicious_anemia.html

Encyclopedia Index P Home Encyclopedia Encyclopedia Index P Pernicious anemia Definition Pernicious anemia is a disease in which the red blood cells are abnormally formed, due to an inability to absorb vitamin B . True pernicious anemia refers specifically to a disorder of atrophied parietal cells leading to absent intrinsic factor, resulting in an inability to absorb B Description Vitamin B , or cobalamin, plays an important role in the development of red blood cells. It is found in significant quantities in liver, meats, milk and milk products, and legumes. During the course of the digestion of foods containing B , the B becomes attached to a substance called intrinsic factor. Intrinsic factor is produced by parietal cells which line the stomach. The B -intrinsic factor complex then enters the intestine, where the vitamin is absorbed into the bloodstream. In fact, B can only be absorbed when it is attached to intrinsic factor. In pernicious anemia, the parietal cells stop producing intrinsic factor. The intestine is then completely unable to absorb B . So, the vitamin passes out of the body as waste. Although the body has significant amounts of stored B

35. Pernicious Anemia pernicious anemia. Definition. pernicious anemia is a disease in which the red bloodcells are abnormally formed, due to an inability to absorb vitamin B 12 . http://www.chclibrary.org/micromed/00060440.html

Main Search Index Definition Description Causes ... Resources Pernicious anemia Definition Pernicious anemia is a disease in which the red blood cells are abnormally formed, due to an inability to absorb vitamin B . True pernicious anemia refers specifically to a disorder of atrophied parietal cells leading to absent intrinsic factor, resulting in an inability to absorb B Description Vitamin B , or cobalamin, plays an important role in the development of red blood cells. It is found in significant quantities in liver, meats, milk and milk products, and legumes. During the course of the digestion of foods containing B , the B becomes attached to a substance called intrinsic factor. Intrinsic factor is produced by parietal cells which line the stomach. The B -intrinsic factor complex then enters the intestine, where the vitamin is absorbed into the bloodstream. In fact, B can only be absorbed when it is attached to intrinsic factor. In pernicious anemia, the parietal cells stop producing intrinsic factor. The intestine is then completely unable to absorb B . So, the vitamin passes out of the body as waste. Although the body has significant amounts of stored B

36. Pernicious Anemia - Treatment By Immunoadsorption indications. Treatment of Autoimmune diseases by Immunoadsorption TREATMENTBY IMMUNOADSORPTION. pernicious anemia -. pernicious anemia. http://www.tsolkas.de/englisch/Unbenannt/pernicious_anemia/pernicious_anemia.htm

var t = ""; document.write(""); var t = ""; document.write(""); (*) = is being discussed. Single case reports Neurological Diseases Guillain-Barré-Syndrome Myasthenia Gravis Multiple Sclerosis Parkinson ... Muscle Wasting Nephrological Diseases Goodpasture Syndrome Focal Sclerosing Glomerulonephritis Rheumatoid Diseases Systemic Lupus Erythematodes SLE Sjögren Syndrome Mixed Collagenosis R ... heumatoid Arthritis Skin Diseases Pemphigus Vulgaris / Foliaceus Pemphigoid Psoriasis Enteropathies Primary Biliary Cirrhosis Gluten Sensitive Enteropathy GSE C eliac Disease ... Crohns Disease* Endokrinological Diseases Malignant Exophthalmus Diabetes Mellitus IDDM Heart Disease Dilative Cardiomyopathy DCM Hematology ITP ( Immunogene Thrombocytopenic Purpura ) TTP ( Thrombotic Thrombocytopenic Purpura ) Hemophilia A and B Plasmocytoma - Pernicious Anemia Immunoadsorption has been previously applied in clinical treatment with these indications Treatment of Autoimmune diseases by Immunoadsorption TREATMENT BY IMMUNOADSORPTION - Pernicious Anemia - Pernicious Anemia

37. Pernicious Anemia - Treatment By Immunoadsorption mail Panos@tsolkas.de. Treatment of Autoimmune diseases by ImmunoadsorptionTREATMENT BY IMMUNOADSORPTION. pernicious anemia -. http://www.tsolkas.de/englisch/Unbenannt/pernicious_anemia/pernicious_anemia1/pe

var t = ""; document.write(""); var t = ""; document.write(""); Information for the patient Since several years the immunoadsorption has been successfully applied for different immunological illnesses. It was always chosen when the patient could not be helped with medicines solely. Immunoadsorption is not comparable with plasmapheresis, because immunoadsorption only removes the immunoglobulins from the blood. Immunoadsorption has been previously applied in clinical treatment with these indications Neurological Diseases - Guillain-Barré-Syndrome - Myasthenia Gravis - Multiple Sclerosis - Muscle Wasting* - Parkinson* Nephrological Diseases - Goodpasture Syndrome - Focal Sclerosing Glomerulonephritis Rheumatoid Diseases - Systemic Lupus Erythematodes SLE - Sjögren Syndrome - Mixed Collagenosis - Rheumatoid Arthritis Enteropathies - Primary Biliary Cirrhosis - Gluten Sensitive Enteropathy GSE - Celiac Disease - Sprue - Inflammatory Bowel Diseases* - Ulcerative Colitis* - Crohns Disease* Endokrinological Diseases: - Malignant Exophthalmus - Diabetes Mellitus IDDM Skin Diseases - Pemphigus Vulgaris / Foliaceus - Pemphigoid - Psoriasis* Hematology - ITP ( Immunogene Thrombocytopenic Purpura ) -TTP ( Thrombotic Thrombocytopenic Purpura ) - Hemophilia A and B - Plasmocytoma - Pernicious Anemia Heart Disease - Dilative Cardiomyopathy DCM * is being discussed. Single case reports

38. Pernicious Anemia - AnsMe.com Dictionary (define) Dictionary pernicious anemia. Definition for pernicious anemia. perniciousanemia (noun) -. 1. a chronic progressive anemia of older http://define.ansme.com/words/p/pernicious_anemia.html

Search: Web Sites Dictionary - Define Dictionary - Sounds Like Dictionary - Relations Dictionary - Rhymes Dictionary - Translate Sponsors Index permutableness permutation permute Pernambuco ... pernicious anaemia pernicious anemia perniciously perniciousness pernickety pernio ... Pernod Dictionary - pernicious anemia Show Definition Sounds Similar Relations Rhymes Translate Definition for pernicious anemia pernicious anemia (noun) a chronic progressive anemia of older adults; thought to result from a lack of intrinsic factor (a substance secreted by the stomach that is responsible for the absorption of vitamin B12) Synonyms: pernicious anaemia malignant anemia malignant anaemia Source: WordNet ® 1.7, © 2001 Princeton University All other brands are property of their respective owners. Directory Dictionary AIM Smileys Contact Us

39. University Of Miami School Of Medicine - Glossary - Pernicious Anemia pernicious anemia. pernicious anemia. pernicious anemia is a blood disorder causedby a lack of vitamin B12. Nowadays, pernicious anemia is not so pernicious. http://www.med.miami.edu/patients/glossary/art.asp?ArticleKey=1966

40. Pernicious Anemia pernicious anemia,. pernicious anemia occurs most often in persons older than35 years and is more common in individuals of northern European descent. http://www.britannica.com/nobel/micro/460_52.html

pernicious anemia, slow-developing disease in which the production of red blood cells is impaired as the result of a vitamin B deficiency. An absence of hydrochloric acid in gastric secretions (achlorhydria) is also characteristic of this condition. Pernicious anemia is one of many types of anemia, a disease marked by a reduction in red blood cells or in the oxygen-carrying substance hemoglobin found in those cells. Anemias are distinguished from one another by cause, symptoms, and cell characteristics. In pernicious anemia, vitamin B , which is necessary for red blood cells to mature properly in the bone marrow, is unavailable owing to a lack of intrinsic factor, a substance responsible for the intestinal absorption of the vitamin. In a healthy person, intrinsic factor is produced by the parietal cells of the stomach, the cells that also secrete hydrochloric acid. In the stomach, intrinsic factor forms a complex with vitamin B . This complex remains intact, preventing degradation of the vitamin by intestinal juices, until it reaches the ileum of the small intestine, where the vitamin is released and absorbed into the body. Pernicious anemia results either when intrinsic factor is prevented from binding with vitamin B or when the parietal cells are unable to produce intrinsic factor. This is believed to stem from an autoimmune reaction in which the body produces antibodies against intrinsic factor and against the parietal cells, destroying them.

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