Kollipara Venkateswara K, Brine Patrick L, Gemmel David, Ingnam Sisham
Mercy Health St Elizabeth Health Center, Youngstown, OH, USA;
Mercy Health St Elizabeth Health Center, Youngstown, OH, USA.
J Community Hosp Intern Med Perspect. 2016 Sep 7;6(4):32493. doi: 10.3402/jchimp.v6.32493. eCollection 2016.
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.
恶性贫血是一种具有多种临床表现的自身免疫性疾病。我们描述了一例以全血细胞减少伴溶血特征为表现的恶性贫血病例。进一步检查发现维生素B12水平极低且甲基丙二酸升高。对于普通内科医生来说，将恶性贫血识别为全血细胞减少和溶血性贫血的病因之一很重要，以避免进行广泛的检查。恶性贫血可能仅表现为血液学异常而无神经系统问题，反之亦然，如我们的病例所示。
