Thank you Dr. Kumar for an excellent case presentation on vitamin B12 deficiency secondary to pernicious anemia in a patient with Graves’ disease and Vitiligo.
Key Learning Points:
- Remember: B12 (cobalamin) levels are neither sensitive nor specific for the diagnosis of B12 deficiency
- Expect to see elevated methylmalonic acid and/or homocysteine levels
- Test for pernicious anemia if there is B12 deficiency and suspicion for other underlying autoimmune disease
- Diagnosis of pernicious anemia is made by testing Intrinsic Factor Ab
- Outcomes if neurological symptoms: expect to see recovery in appx 1 week and resolution in 6-12 weeks. Symptoms may be irreversible if diagnosis is delayed
For more information, see this review article below for a comprehensive overview of pernicious anemia: