Biermer disease

Biermer's disease, also known as pernicious anemia, is a type of anemia characterized by a decrease in red blood cells when the body can't absorb enough vitamin B12. The disease is named after the German physician Anton Biermer who first described it in the 19th century.

Causes

Biermer's disease is primarily caused by an autoimmune process that destroys the gastric mucosa, the lining of the stomach, which is necessary for the absorption of vitamin B12. This destruction leads to a lack of intrinsic factor, a protein essential for vitamin B12 absorption. Without intrinsic factor, vitamin B12 cannot be absorbed, regardless of dietary intake.

Symptoms

The symptoms of Biermer's disease are related to the resulting vitamin B12 deficiency and may include:

• Fatigue
• Weakness
• Pale skin
• Glossitis (inflammation of the tongue)
• Neuropathy (nerve damage), leading to tingling and numbness in the hands and feet
• Memory loss and cognitive changes
• Megaloblastic anemia, characterized by the presence of abnormally large red blood cells

Diagnosis

Diagnosis of Biermer's disease involves a combination of clinical evaluation and laboratory tests, including:

• Complete blood count (CBC), which shows megaloblastic anemia
• Serum vitamin B12 levels, which are typically low
• Presence of autoantibodies against intrinsic factor or gastric parietal cells
• Methylmalonic acid and homocysteine levels, which are elevated in vitamin B12 deficiency

Treatment

The primary treatment for Biermer's disease is the administration of vitamin B12. This can be done through:

• High-dose oral vitamin B12 supplements, if the patient can absorb some vitamin B12
• Vitamin B12 injections, which are necessary in cases where the patient cannot absorb vitamin B12 from the gastrointestinal tract

Lifelong treatment is usually required to prevent recurrence of symptoms.

Prognosis

With proper treatment, individuals with Biermer's disease can lead a normal life. However, untreated, the disease can lead to severe complications, including irreversible nerve damage and increased risk of gastric cancer.

Epidemiology

Biermer's disease is more common in individuals of Northern European descent and is rare in children. It typically presents in middle-aged or older adults.

Biermer disease Resources
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