Andres Emmanuel, Serraj Khalid
Department of Internal Medicine, Diabetes, and Metabolic Disorders, University Hospital of Strasbourg, Strasbourg, France ; Competence Center of Autoimmune Cytopenias in Adults, University Hospital of Strasbourg, Strasbourg, France.
J Blood Med. 2012;3:97-103. doi: 10.2147/JBM.S25620. Epub 2012 Sep 10.
Pernicious anemia (also known as Biermer's disease) is an autoimmune atrophic gastritis, predominantly of the fundus, and is responsible for a deficiency in vitamin B12 (cobalamin) due to its malabsorption. Its prevalence is 0.1% in the general population and 1.9% in subjects over the age of 60 years. Pernicious anemia represents 20%-50% of the causes of vitamin B12 deficiency in adults. Given its polymorphism and broad spectrum of clinical manifestations, pernicious anemia is a great pretender. Its diagnosis must therefore be evoked and considered in the presence of neurological and hematological manifestations of undetermined origin. Biologically, it is characterized by the presence of anti-intrinsic factor antibodies. Treatment is based on the administration of parenteral vitamin B12, although other routes of administration (eg, oral) are currently under study. In the present update, these various aspects are discussed with special emphasis on data of interest to the clinician.
恶性贫血（也称为比尔默氏病）是一种自身免疫性萎缩性胃炎，主要累及胃底，由于维生素B12（钴胺素）吸收不良导致其缺乏。其在普通人群中的患病率为0.1%，在60岁以上人群中为1.9%。恶性贫血占成人维生素B12缺乏原因的20% - 50%。鉴于其多态性和广泛的临床表现谱，恶性贫血很容易被误诊。因此，在存在不明原因的神经和血液学表现时，必须考虑并怀疑其诊断。从生物学角度看，其特征是存在抗内因子抗体。治疗基于胃肠外给予维生素B12，尽管目前正在研究其他给药途径（如口服）。在本综述中，将对这些不同方面进行讨论，并特别强调临床医生感兴趣的数据。
