foreign disorder characterized by a decrease in the production of red blood cells due to lack of vitamin B12 an essential component for the development of red blood cells in perdicious anemia a protein found in the stomach called intrinsic factor or if or the stomach cells that produce iaf are attacked by the immune system intrinsic factor normally binds to vitamin B12 to allow the vitamin to be absorbed through the gastrointestinal tract when there is insufficient intrinsic factor vitamin B12 cannot be absorbed ultimately leading to a decrease in red blood cell production now the symptoms of pernicious anemia may include weakness fatigue abdominal discomfort after eating or drinking palpitations mouth ulcers or even weight loss jaundice or yellowing of the skin or sclera can also occur in more severe cases symptoms can be due to damage to neurons and present as paresthesia or pins and needle Sensations spasticity or abnormal muscle tone and imbalance the diagnosis of pernicious anemia is based on the individual's detailed medical history and thorough clinical evaluation however blood tests are required to confirm the diagnosis blood tests can include a complete blood count or CBC vitamin B12 levels peripheral smear and antibody testing typically the CBC will show an increase in mean corpuscular volume or MCV vitamin b12s may be low and a peripheral smear may show macro ovallocytes or large oval-shaped red blood cells and hyper-segmented neutrophils or a type of white blood cell with multi-lobed nuclei finally antibody testing can show antibodies against intrinsic factor and gastric cells that produce it which can confirm the diagnosis other blood tests may also be done if an underlying condition is suspected now treatment involves lifelong supplementation of vitamin B12 intramuscular injections of vitamin B12 are the preferred method of administration and are usually taken every day or every other day for the first week of therapy then weekly injections occur for one to two months followed by maintenance therapy with monthly injections by supplementing with intramuscular vitamin B12 the body is able to bypass the gastrointestinal tract and absorb the vitamin without the need for intrinsic factor alright as a quick recap pernicious anemia is an autoimmune disease characterized by a decrease in the production of red blood cells due to a lack of vitamin B12 absorption symptoms can include fatigue jaundice oral ulcers or neurologic symptoms diagnosis includes a thorough history physical exam and Laboratory Testing treatment involves lifelong supplementation of vitamin B12 injections helping current and future clinicians Focus learn retain and Thrive learn more