Pernicious Anemia
A type of megaloblastic anemia that is due to lack of intrinsic factor which is necessary to absorb vitamin B12. The client has good intake of Vitamin B12 but it cannot be absorbed.
Pernicious/Megaloplastic Anemia
Megaloplastic Anemia Very Large Red Blood Cells
Characterized by a deficiency of Vitamin B12 and folic acid.
Patho
Complete blood count. reticulocyte count. Blood tests to measure of vitamin B12, methylmalonic acid (MMA), or homocysteine levels.
Diagnosis
Poor intake. Diets such as vegetarian diets and low-dairy intake.
Causes
Angular cheilitis (scaling lips/corner of the mouth), smooth-bright red tongue, sensitiivty to cold & dyspnea.
Symptoms
Pernicious Anemia Lack of Intrinsic Factor
Intestines cannot absorb B12 due to lack of intrinsic factor. The client is ingesting Vitamin 12, but it is not absorbed. Intestines do not make intrinsic factor.
Patho
Schilling test no longer done. Diagnosis is now performed by lab tests such as anti-intrinsic factor antibodies.
Diagnosis
Small bowel resection, gastric surgery/problems, chronic diarrhea, Irritable bowel disease, diverticula, tapeworms, & overgrowth of intestinal bacteria.
Causes
Angular cheilitis (scaling lips/corner of the mouth), smooth-bright red tongue, sensitiivty to cold & dyspnea.
Symptoms
- Pernicious anemia: Needs INJECTED vitamin B12 weekly, then monthly for the rest of their lives (cannot absorb B12, remember?)
- Hydrocobalamin = Vitamin B12
- Vitamin B12 nasal spray (cyanocobalamin aka Calomist)
- Where to inject B12? Ventrogluteal and dorsogluteal muscle.
- Again, these clients cannot take oral supplements.
- Increased dietary intake of Vitamin B12 (meat, poultry, shellfish, eggs, & dairy).
- Deficiency first treated with injections then oral B12 can be prescribed.