Enfermedades autoinmunitarias asociadas a diabetes mellitus tipo 1A. Autoimmune diseases in type 1A diabetes mellitus. Correspondencia a :. Its frequency is gradually increasing in countries like Mexico.
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Pernicious anemia. From past to present. Pernicious anemia is currently the most common cause of vitamin B12 deficiency in Western countries. The histological lesion upon which this condition is based is autoimmune chronic atrophic gastritis.
The destruction of parietal cells causes a deficiency in intrinsic factor, an essential protein for vitamin B12 absorption in the terminal ileum. Advances in the last two decades have reopened the debate on a disease that seemed to have been forgotten due to its apparent simplicity. The new role of H. All rights reserved. Directory of Open Access Journals Sweden. Full Text Available Introduction. Acquired thrombotic thrombocytopenic purpura TTP has been associated with different autoimmune disorders.
However, its association with pernicious anemia is rarely reported. Case Report. A year-old male presented with blood in sputum and urine for one day. The vitals were stable. The physical examination was significant for icterus. He had an elevated LDH, low haptoglobin levels with many schistocytes, nucleated RBCs, and reticulocytes on peripheral smear. The rest of the immunological workups were negative.
Subsequently, his symptoms resolved and his hematological parameters improved. While pernicious anemia can masquerade as TTP, an actual association between the two can also occur and needs further evaluation and characterization.
A case of asymptomatic pancytopenia with clinical features of hemolysis as a presentation of pernicious anemia. Full Text Available Pernicious anemia is an autoimmune disease with a variety of clinical presentations. We describe a case of pernicious anemia presenting with pancytopenia with hemolytic features. Further workup revealed very low vitamin B12 levels and elevated methylmalonic acid. It is important for a general internist to identify pernicious anemia as one of the cause of pancytopenia and hemolytic anemia to avoid extensive workup.
Pernicious anemia can present strictly with hematological abnormalities without neurological problems or vice versa as in our case.
However, the coexistence of myasthenia gravis and pernicious anemia is rare. Here, we report a year-old Taiwanese woman who developed myasthenia gravis 5 months after the onset of pernicious anemia. Her myasthenic and pernicious anemia symptoms markedly improved after pyridostigmine, prednisolone and hydroxo-cobalamine treatment.
It is important to recognize concurrence of myasthenia gravis and pernicious anemia in the same patient because the therapeutic results for both diseases are rewarding. Pernicious anemia and juvenile-onset diabetes mellitus in an adolescent: a case report. We report a case of a year-old black boy who developed juvenile-onset pernicious anemia in association with insulin-dependent diabetes mellitus. He had both intrinsic factor and parietal cell antibodies in addition to anti-islet cell surface antibodies.
The existence of pernicious anemia and diabetes mellitus in such a young child makes this an unusual case. Full Text Available In a recent paper, we proposed that a contributing factor in autism is a deficiency in cholesterol sulfate supply. In this paper, we investigate a link between preeclampsia and subsequent autism in the child, and we hypothesize that both conditions can be attributed to a severe depletion of cholesterol sulfate.
Through studies on the Vaccine Adverse Event Reporting System VAERS database, we demonstrate a strong statistical relationship among the signs and symptoms associated with autism and those associated with preeclampsia, pernicious anemia , and serious adverse reactions to vaccines. We show that VAERS reports associated with symptoms typical of pernicious anemia produce both a set of symptoms that are highly correlated with preeclampsia and another set highly correlated with autism.
We explain this observation via an argument that, in a severe reaction, the cascade of events subsequent to vaccination reflects a profuse production of nitric oxide NO and consequential destruction of both red blood cells RBCs and cobalamin. This may explain the diverse signs and symptoms associated with both preeclampsia and severe vaccine adverse reactions.
We argue that excess NO synthesis, induced by the aluminum and antigen in vaccines, results in hemolysis of RBCs, which allows hemoglobin to scavenge the excess NO, converting it to nitrate. The NO is also scavenged by cobalamin, leading to its inactivation and contributing to subsequent pernicious anemia. Finally, we demonstrate that severe adverse reactions to vaccines can be associated with life-threatening conditions related to the heart and brain, as well as stillbirth, when the vaccine is administered to a woman in the third-trimester of pregnancy, as demonstrated by statistical analysis of the Gardasil records.
On May 19th a year-old Chinese man was admitted to a hospital at Yogyakarta Indonesia on account of a sawing noise in both ears and some soreness of the tongue. He had macrocytic anemia haemoglobin: 3. A presumptive diagnosis of pernicious anaemia was confirmed by gastric analysis which revealed a histamine fast achlorhydria. On treatment with vitamin B12 the noise in the ears rapidly disappeared and there was a characteristic rise in reticulocytes and haemoglobin content.
After 3 years the patient died of inoperable gastric carcinoma. There probably was a hereditary component as in a year-old cousin, who also suffered and died from gastric carcinoma, gastric analysis showed a histamine fast achlorhydria. The patient is the first case of pernicious anaemia described in a Chinese resident of Indonesia. A survey of the literature revealed that until now pernicious anaemia has been recorded in 31 Chinese patients, in chronological order from the following countries: U.
In the autochthonous Chinese population no case has yet been reported. A case of autoimmune polyglandular syndrome APS is presented. A year-old man was admitted due to fatigue, malaise and inappetence. He had a history of primary hypothyroidism and was on levothyroxine substitution therapy.
One year before, he was diagnosed with normocytic anemia and vitamin B12 deficiency, which was treated with vitamin B12 substitution therapy. Physical examination revealed hypotension and marked hyperpigmentation. Laboratory testing showed hyponatremia, hyperkaliemia and severe normocytic anemia. Endocrinological evaluation disclosed low morning cortisol and increased adrenocorticotropic hormone levels.
Hence, the diagnosis of Addison's disease was established. Additional laboratory workup showed positive parietal cell antibodies.
However, his vitamin B12 levels were increased due to vitamin B12 supplementation therapy, which was initiated earlier. Gastroscopy and histopathology of gastric mucosa confirmed atrophic gastritis. Based on prior low serum vitamin B12 levels, positive parietal cell antibodies and atrophic gastritis, the patient was diagnosed with pernicious anemia. Hydrocortisone supplementation therapy was administered and titrated according to urinary-free cortisol levels. Electrolyte disbalance and red blood cell count were normalized.
This case report demonstrates rather unique features of pernicious anemia in a patient with Addison's disease. Not only do they share the same etiological factors, but also overlap in pathophysiological and clinical characteristics. This case report favors older classification of APS, which consolidates all endocrine and other organ-specific autoimmune diseases into one category.
This is important since it might help avoid pitfalls in the diagnosis and treatment of patients with APS. Reliability of the dual-isotope Schilling test for the diagnosis of pernicious anemia or malabsorption syndrome.
To evaluate the dual-isotope Schilling test for the diagnosis of pernicious anemia or malabsorption syndrome, 65 studies were selected for clinical correlation. Criteria for malabsorption syndrome included: decreased serum B12, folate, and carotene; increased fecal fat; abnormal D-xylose absorption; abnormal radiographic and biopsy findings.
Aliquots of hour urine samples were counted. Pernicious Anemia. Research suggests a link may exist The patient also reported a 1-month history of jaundice. On examination, he was hemodynamically stable and afebrile with pallor and diffuse jaundice but without skin rash or palpable purpura.
Normal sensations and power in all extremities were evident on neurological exam. Presence of hemolytic anemia , schistocytosis, thrombocytopenia, and elevated lactate dehydrogenase LDH was suggestive of thrombotic thrombocytopenic purpura TTP.
However, presence of leukopenia, macrocytes, and an inadequate reticulocyte response to the degree of anemia served as initial clues to an alternative diagnosis. Two and one units of packed red blood cells were transfused on day 1 and day 3, respectively. In addition, one unit of platelets was transfused on day 2. A low cobalamin vitamin B12 level was evident at initial laboratory work-up and subsequent testing revealed positive intrinsic factor-blocking antibodies supporting a diagnosis of pernicious anemia with severe cobalamin deficiency.
Hematological improvement was observed following vitamin B12 supplementation. The patient was discharged and markedly improved on day 9 with outpatient follow-up for cobalamin supplementation.
Study on histogenesis of enterochromaffin-like carcinoid in autoimmune atrophic gastritis associated with pernicious anemia. Autoimmune atrophic fundic gastritis induces the pernicious anemia PA, as well as the changes in both epithelium and endocrine cells of gastric mucosa. The most important complications are: achlorhydria, hypergastrinemia, gastric cancer and enterochromaffin-like ECL carcinoid.
Both G and ECL cells were counted per 20 fields, of surface 0. Basal gastrin serum levels were also examined by using radioimmunoassay RIA method. Marked antral G cell hyperplasia associated with corporal ECL hyperplasia was found.
ECL cell hyperplasia was of simplex, linear, adenomatoid type to the pattern of intramucous ECL cell carcinoid. An average number of G cells was statistically significant in the patients with PA as compared to the control group p Acute myocardial infarction and pulmonary embolism in a young man with pernicious anemia -induced severe hyperhomocysteinemia.
Full Text Available Abstract A 27 year-old man who presented to the hospital with progressive lower extremity weakness, developed an acute ST elevation myocardial infarction on his second hospital day. Primary angioplasty to the left anterior descending coronary artery was performed.
Due to persistent dyspnea, the patient underwent a diagnostic chest computed tomography which confirmed multiple small pulmonary emboli.
Laboratory analysis revealed a megaloblastic anemia with a reduced vitamin B12 level and positive titers for antibodies against intrinsic factor, establishing a diagnosis of pernicious anemia. No other significant risk factors for coronary artery disease including a family history of premature atherosclerosis were identified.
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