Pernicious Anemia: Diagnosis

Also from Answers.com... Heart Disease CAD Go inside the body to see how heart disease develops.

More about Pernicious Anemia: Definition Causes and symptoms Diagnosis Treatment Prognosis Resources

Diagnosis of pernicious anemia is suggested when a blood test reveals abnormally large red blood cells. Many of these will also be abnormally shaped. The earliest, least mature forms of red blood cells (reticulocytes) will also be low in number. White blood cells and platelets may also be decreased in number. Measurements of the quantity of B₁₂ circulating in the bloodstream will be low.

Once these determinations are made, it will be important to diagnose the cause of the anemia. True pernicious anemia means that the parietal cells of the stomach are atrophied, resulting in decreased production of intrinsic factor. This diagnosis is made by the Schilling test. In this test, a patient is given radioactive B₁₂ under two different sets of conditions: once alone, and once attached to intrinsic factor. Normally, large amounts of B₁₂ are absorbed through the intestine, then circulate through the blood, and enter the kidneys, where a certain amount of B₁₂ is then passed out in the urine. When a patient has pernicious anemia, the dose of B₁₂ given by itself will not be absorbed by the intestine, so it will not pass into the urine. Therefore, levels of B₁₂ in the urine will be low. When the B₁₂ is given along with intrinsic factor, the intestine is able to absorb the vitamin. Urine levels of B₁₂ will therefore be higher.

— Rosalyn Carson-DeWitt, MD