Pernicious anemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Laboratory Findings

A diagnosis of pernicious anaemia first requires demonstration of megaloblastic anaemia (through a full blood count) and of its direct cause, vitamin BTemplate:Ssub deficiency (by measuring BTemplate:Ssub levels in serum). A Schillings test can then be used to distinguish pernicious anemia from other causes of vitamin BTemplate:Ssub deficiency (notably malabsorption. A diagnosis of atrophic gastritis should be confirmed by gastroscopy with biopsies. Approximately 90% of individuals with pernicious anemia have antibodies for parietal cells, however only 50% of individuals with these antibodies have pernicious anaemia.

  • Tests that may used to diagnose or monitor pernicious anemia include:
  • Complete blood count (CBC)
  • Reticulocyte count
  • Schilling test
  • Serum LDH
  • Serum methylmalonic acid (MMA) level
  • Serum vitamin B12 level
  • Bone marrow examination (only needed if diagnosis is unclear)
  • Measurement of serum holotranscobalamin II
  • Pernicious anemia may also affect the results of the following tests:
  • Bilirubin
  • Cholesterol test
  • Gastrin
  • Leukocyte alkaline phosphatase
  • Peripheral smear
  • TIBC
  • Vitamin B12 deficiency affects the appearance of cells that form on the outer surface of the body and line inner passageways (epithelial cells). An untreated woman may have a false positive Pap smear.

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