A Multicenter Retrospective Analysis of the Clinical Features of Pernicious Anemia in a Korean Population

To determine the approximate incidence and clinical features of pernicious anemia in a Korean population, we retrospectively analyzed clinical data for patients with pernicious anemia who were diagnosed between 1995 and 2010 at five hospitals in Chungnam province. Ninety-seven patients were enrolled, who accounted for 24% of patients with vitamin B12 deficiency anemia. The approximate annual incidence of pernicious anemia was 0.3 per 100,000. The median age was 66 (range, 32-98) yr, and the male/female ratio was 1.25. Anemia-associated discomfort was the most common symptom (79.4%), followed by gastrointestinal and neurological symptoms (78.4% and 38.1%, respectively). Pancytopenia was found in 36 patients (37.1%), and autoimmune disorders were found in 15 patients (15.5%). Antibody to intrinsic factor was detected in 62 (77.5%) of 80 patients examined, and antibody to parietal cells was detected in 35 (43.2%) of 81 patients examined. Of the 34 patients who underwent tests for Helicobacter pylori, 7 (12.5%) were positive. The anemia-associated and gastrointestinal symptoms resolved completely in all patients after intramuscular injection of cobalamin, whereas neurological symptoms remained in some. In conclusion, pernicious anemia is less frequent in Koreans than in Western populations; however, the clinical features of this disorder in Koreans do not differ from those of Western cases.

Pernicious Anemia: A Retrospective Analysis of 22 Cases

BACKGROUND: Pernicious anemia is the most common cause of vitamin B12 deficiency in western populations, but to date, only case reports or small series dealing with this malady have been reported in Korea. This study describes the clinical characteristics of pernicious anemia in Koreans. METHODS: We retrospectively analyzed the clinical data for twenty-two Korean patients with pernicious anemia who were diagnosed during the period from 1995 to 2004 at Chungnam National University Hospital. RESULTS: Only two patients were diagnosed before 2000. The median age of the patients was 66 years and the male/female ratio was 1.8. Anemia-associated discomfort was the most common symptom (95.5%); this was followed by gastrointestinal and neurological symptoms (77.2% and 50.0%, respectively). Autoimmune disorders were found in five patients (22.7%). The median hemoglobin level was 7.0g/dL (range: 3.1~11.8g/dL) and pancytopenia was found in 12 patients (54.5%). The median serum vitamin B12 Level was 26pg/mL (range: 12~189pg/mL). Fifteen (78.9%) and eight (42.1%) of the 19 patients who underwent tests for antibodies were positive for anti-intrinsic factor and anti-parietal cell antibody, respectively. Nineteen of 21 patients who were treated with intramuscular cobalamin recovered from their cytopenia within 3 months. The gastrointestinal symptoms resolved completely for all the patients, while neurological symptoms remained for some of the patients. CONCLUSION: This study shows that the clinical features of pernicious anemia in Koreans are not different from those of the western cases. In addition, pernicious anemia is not a rare finding in Korea.