Did You Know Your Mouth Could Signal Pernicious Anemia?

Pernicious anemia oral symptoms

Question. Write a short note on clinical features (with emphasis on oral manifestations) and diagnosis of pernicious anemia.
Or
Write a short note on the clinical features and laboratory investigations of Pernicious Anemia.
Answer.

“Early warning signs of pernicious anemia in oral health”

Pernicious anemia is also called primary anemia, Addison’s anemia, or Biermer’s anemia.

The term pernicious anemia is given to patients who have a vitamin B12 deficiency, which is secondary to an intrinsic factor deficiency.

“Understanding pernicious anemia: Causes and oral symptoms”

Pernicious Anemia and Oral Symptoms: How Your Mouth Signals the Disease

Pernicious Anemia Clinical Features

• It is rare before the age of 30 years and increases frequently with advancing age. Males are more commonly affected than females.
• There is a triad of symptoms, i.e,. generalized weakness, sore, painful tongue, and numbness and tingling ofthe extremities.
• Other features are fatigability, headache, dizziness, nausea, vomiting, diarrhea, loss of appetite, shortness of breath, loss of weight, pallor, and abdominal pain.
• In the nervous system, sensory disturbances are present, such as paresthesia of extremities, stiffness as well as difficulty in the walking, irritability and depression, drowsiness, incoordination, of loss of vibratory sensation. Presence of tingling sensation in fingers and toes, which progresses to numbness.
• Presence of gastrointestinal symptoms such as constipation, diarrhea,hea, and epigastric discomfort.

“Importance of recognizing oral signs of pernicious anemia”

Pernicious Anemia Oral Manifestations

• Presence of glossitis and the patient complains of painful and burning lingual sensation.
• The tongue is inflamed and is beefy red within entirely or in patches, scattered over the dorsum and lateral border of the tongue.
• There is atrophy of papillae of the tongue, which eventuates in a smooth and bald tongue, which is referred to as Hunter’s glossitis or Moller’s glossitis.
• The fiery red appearance of the tongue may undergo remission, but recurrent attacks are common.
• There is a disturbance in taste sensations with intolerance to dentures and occasional dryness of the mouth.
• Oral mucosa shows greenish-yellow color at the junction of the hard and soft palate when daylight is used for illumination.

Mouth Signs of Pernicious Anemia: Symptoms You Should Not Ignore

“Common causes of pernicious anemia explained through oral health”

Pernicious Anemia Diagnosis

The diagnosis is based on the laboratory investigations, i.e.

• RBC count is decreased often to 3 or fewer per cubic mm
• Many of the cells exhibit macrocytosis, while some exhibit poikilocytosis.

Oral Manifestations of Pernicious Anemia: Glossitis, Sores, and More

“Pathophysiology of pernicious anemia oral symptoms explained”

• Decreased WBC count and MCH
• Bone marrow shows a great number of immature red cells or megaloblasts with few normoblasts.
• Schilling test detects the absence of intrinsic factor.
• In advanced cases, there is the presence of polychromatophilic cells, stippled cells, nucleated cells, Howell-Jolly bodies, and cobalt’s ring.

The above tests confirm the diagnosis.