Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China

Background Pernicious anemia (PA) is believed to be highly prevalent in Western countries but has rarely been reported in China. The study explores whether PA, an autoimmune disease, is an uncommon cause of cobalamin (vitamin B12) deficiency anemia in China.Methods Clinical and hematological data we...

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Main Authors: Meixiao Shen, Xiansheng Luo, Cuiyun Wu, Juan Wang, Zhiming Wang, Meiqing Lei
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2024.2399375
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author Meixiao Shen
Xiansheng Luo
Cuiyun Wu
Juan Wang
Zhiming Wang
Meiqing Lei
author_facet Meixiao Shen
Xiansheng Luo
Cuiyun Wu
Juan Wang
Zhiming Wang
Meiqing Lei
author_sort Meixiao Shen
collection DOAJ
description Background Pernicious anemia (PA) is believed to be highly prevalent in Western countries but has rarely been reported in China. The study explores whether PA, an autoimmune disease, is an uncommon cause of cobalamin (vitamin B12) deficiency anemia in China.Methods Clinical and hematological data were collected from 90 cobalamin deficiency-caused megaloblastic anemia (MA) patients between July 2014 and December 2021. Through anti-intrinsic factor antibody (IFA) and anti-parietal cell antibody (PCA) testing, PA was distinguished from other causes of cobalamin deficiency leading to MA. Meanwhile, 30 healthy controls (HCs) were included to estimate the positive rates of IFA and PCA.Results Of the 30 HCs, only one tested positive for IFA, and all 30 tested negative for PCA. Among the 90 patients with cobalamin deficiency-caused MA, 76.7% were positive for IFA, and 47.8% were positive for PCA; a total of 76 patients (84.4%) were diagnosed with PA. The mean follow-up time was 41.0 ± 16.3 months. During the follow-up period, no case relapsed among the continuous cobalamin-supply treatment patients, while 24.4% of patients relapsed due to the interruption of maintenance cobalamin-supplement therapy (the median recurrence time was 54.0 ± 17.7 months).Conclusions The proportion of PA in cobalamin deficiency-caused MA patients in Hainan province was higher than 80%, which was more common than expected. Therefore, screening for IFA, PCA, endoscopic biopsy, and thyroid-related parameters are recommended for all cobalamin deficiency-caused MA patients. Furthermore, maintenance cobalamin-supplement therapy is important for PA patients.
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spelling doaj-art-e28adad3466541939b80e7d8ebc5b8db2025-08-20T02:34:31ZengTaylor & Francis GroupHematology1607-84542024-12-0129110.1080/16078454.2024.2399375Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, ChinaMeixiao Shen0Xiansheng Luo1Cuiyun Wu2Juan Wang3Zhiming Wang4Meiqing Lei5Department of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, People’s Republic of ChinaDepartment of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, People’s Republic of ChinaDepartment of Laboratory Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, People’s Republic of ChinaDepartment of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, People’s Republic of ChinaDepartment of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, People’s Republic of ChinaDepartment of Hematology, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, People’s Republic of ChinaBackground Pernicious anemia (PA) is believed to be highly prevalent in Western countries but has rarely been reported in China. The study explores whether PA, an autoimmune disease, is an uncommon cause of cobalamin (vitamin B12) deficiency anemia in China.Methods Clinical and hematological data were collected from 90 cobalamin deficiency-caused megaloblastic anemia (MA) patients between July 2014 and December 2021. Through anti-intrinsic factor antibody (IFA) and anti-parietal cell antibody (PCA) testing, PA was distinguished from other causes of cobalamin deficiency leading to MA. Meanwhile, 30 healthy controls (HCs) were included to estimate the positive rates of IFA and PCA.Results Of the 30 HCs, only one tested positive for IFA, and all 30 tested negative for PCA. Among the 90 patients with cobalamin deficiency-caused MA, 76.7% were positive for IFA, and 47.8% were positive for PCA; a total of 76 patients (84.4%) were diagnosed with PA. The mean follow-up time was 41.0 ± 16.3 months. During the follow-up period, no case relapsed among the continuous cobalamin-supply treatment patients, while 24.4% of patients relapsed due to the interruption of maintenance cobalamin-supplement therapy (the median recurrence time was 54.0 ± 17.7 months).Conclusions The proportion of PA in cobalamin deficiency-caused MA patients in Hainan province was higher than 80%, which was more common than expected. Therefore, screening for IFA, PCA, endoscopic biopsy, and thyroid-related parameters are recommended for all cobalamin deficiency-caused MA patients. Furthermore, maintenance cobalamin-supplement therapy is important for PA patients.https://www.tandfonline.com/doi/10.1080/16078454.2024.2399375Pernicious anemiaanti-intrinsic factor antibodyanti-parietal cells antibodyatrophic gastritis
spellingShingle Meixiao Shen
Xiansheng Luo
Cuiyun Wu
Juan Wang
Zhiming Wang
Meiqing Lei
Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China
Hematology
Pernicious anemia
anti-intrinsic factor antibody
anti-parietal cells antibody
atrophic gastritis
title Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China
title_full Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China
title_fullStr Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China
title_full_unstemmed Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China
title_short Pernicious anemia is a common cause of cobalamin deficiency-caused megaloblastic anemia in Hainan, China
title_sort pernicious anemia is a common cause of cobalamin deficiency caused megaloblastic anemia in hainan china
topic Pernicious anemia
anti-intrinsic factor antibody
anti-parietal cells antibody
atrophic gastritis
url https://www.tandfonline.com/doi/10.1080/16078454.2024.2399375
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