Isolated vitamin B12 deficiency due to pernicious anemia in a patient with celiac sprue: a case report

ABSTRACT

Celiac sprue or Celiac disease is an autoimmune enteropathy often seen in patients are sensitive to gluten. Usually due to impaired absorption of iron and folic acid at the proximal of small intestine, iron deficiency anemia and megaloblastic anemia is common, but vitamin B 12 deficiency is rarely reported. We will describe the case that in addition to have celiac disease, without deficiency of iron and folic acid, has deficient vitamin B 12 due to severe pernicious anemia and improved dramatically to treatment with injection of vitamin B12. 38-years-old male patient with complaints of weakness and malaise and abdominal pain is referred. Initial tests indicated patient have megaloblastic anemia caused by vitamin B12 deficiency. With stomach and deuodenal biopsy and serological antibody titration studies including anti-parietal cell antibody, anti-endomysial antibody and tissue transglutaminase, accompanied with pernicious anemia and celiac disease was proved. After diagnosis, patients treated with intramuscular vitamin B12 and regimen without gluten, after one month significant improvements in clinical symptoms and laboratory found