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pernicious anemia
a type of megaloblastic anemia seen most often in older adults, caused by lack of intrinsic factor, which normally is produced by the mucous membrane of the stomach. The deficiency results in inadequate and abnormal formation
of erythrocytes, leukocytes, and platelets, with failure to absorb vitamin B12. Some patients have only mild symptoms, whereas in others it becomes very serious and if untreated can lead to permanent
neurologic impairment and even death. It may be caused by deficient vitamin B12 intake, impaired absorption due to intrinsic factor deficiency, intestinal disease, or increased need for vitamin B12, or something that blocks usage of the vitamin. Many patients have jaundice, a pale, colorless, or lemon-yellow complexion, soreness and reddening of the tongue, difficulty in swallowing, and digestive disturbances such as diarrhea. Other symptoms may include fatigability, heart palpitation, and dyspnea. Changes in the nerves and spinal cord may produce numbness and tingling in the fingers and toes, and the gait may become unsteady.
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