Pernicious anemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

A diagnosis of pernicious anaemia first requires demonstration of megaloblastic anaemia (through a full blood count) and of its direct cause, vitamin BTemplate:Ssub deficiency (by measuring BTemplate:Ssub levels in serum). A Schillings test can then be used to distinguish pernicious anemia from other causes of vitamin BTemplate:Ssub deficiency (notably malabsorption. A diagnosis of atrophic gastritis should be confirmed by gastroscopy with biopsies. Approximately 90% of individuals with pernicious anemia have antibodies for parietal cells, however only 50% of individuals with these antibodies have pernicious anaemia.

• Tests that may used to diagnose or monitor pernicious anemia include:

• Complete blood count (CBC)
• Reticulocyte count
• Schilling test
• Serum LDH
• Serum methylmalonic acid (MMA) level
• Serum vitamin B12 level
• Bone marrow examination (only needed if diagnosis is unclear)
• Measurement of serum holotranscobalamin II

• Pernicious anemia may also affect the results of the following tests:

• Bilirubin
• Cholesterol test
• Gastrin
• Leukocyte alkaline phosphatase
• Peripheral smear
• TIBC

• Vitamin B12 deficiency affects the appearance of cells that form on the outer surface of the body and line inner passageways (epithelial cells). An untreated woman may have a false positive Pap smear.

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