Clinical features are those of vitamin B12 deficiency. However in pernicious anaemia there is an insidious onset and so there may be a profound degree of anaemia at the time of diagnosis.
Possible clinical features of pernicious anaemia include (1,2,3)
- general features include: (premature greying of the hair)
- tiredness/lethargy
- dry skin
- brittle nails
- glossitis - beefy red tongue
- alopecia or greying
- low grade pyrexia
- weight loss
- reduced appetite
- lemon yellow colour:
- jaundice, due to haemolysis
- pallor, due to anaemia
- neurological features include:
- dementia/memory loss/poor concentration
- peripheral neuropathy, subacute combined degeneration of the cord - paraesthesia, numbness, difficulty in walking, weakness
- cardiorespiratory features
- palpitations, shortness of breath
- gastrointestinal features include:
- anorexia, weight loss
- diarrhoea, altered bowel habit, malabsorption
- taste disturbance
- psychological/psychiatric features include:
- depression
- irritability
- emotional lability
- ophthalmalogical features include:
- retrobulbar neuritis - poor vision
- optic atrophy - blindness
Notes:
- incidence of low-grade fever in nutritional megaloblastic anemia varies from 28% to 60% (3)
Reference: