A patient with behavioral alterations due to pernicious anemia

Paciente con anemia perniciosa y cambios comportamentales

Pernicious anemia is a hematologic condition characterized by anemia with an increased mean corpuscular volume, secondary to impaired vitamin B12 absorption due to lack of intrinsic factor. It may be associated with the destruction of parietal gastric cells or the presence of anti-intrinsic factor antibodies which generates decreased serum levels of cyanocobalamin and impair DNA and RNA synthesis. Given it involves the three cell lines it may have a varied symptomatology. Main manifestations are seen in the central and peripheral nervous system and gastrointestinal system. Diagnosis is based on finding low cyanocobalamin serum levels, associated with gastric mucosa anomalies due to atrophic gastritis, which must be confirmed by a biopsy. A case is described in a 68 year old female patient with behavioral alterations and cognitive impairment. Hemogram showed pancytopenia and anemia, increased mean corpuscular volume, as well as decreased serum vitamin B12 level and an endoscopy evidenced chronic erythematous atrophic gastritis. She received vitamin B12 therapy with full cognitive recovery and reversal of behavioral alterations.

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