Pernicious Anemia Research Paper

What Is Pernicious Anemia? Many people around the world die from different serious diseases. One of this disease is anemia. Anemia is a condition that refers to the shortage of healthy red blood cells (Erythrocytes), or it can be deficient of the hemoglobin in the erythrocytes. Anemia is derived from two Greek words “an”, which means lack of, and “haema” which means blood. [1] Anemia has more than 90 types. They are ranging from mild to severe, and they can be long or temporarily term. Each type of anemia has different causes. One of these types is pernicious anemia, which is caused by developing gastritis, loss of normal gastric glands, and atrophy of all stomach layers. Then it develops to a deficiency in vitamin B12 and healthy erythrocytes.

In the first stage in the normal body, vitamin B12 binding proteins that found in saliva to enters the stomach. Then the stomach uses hydrochloric acid to liberate vitamin B12 from the proteins. However, in the first stage of pernicious anemia, the stomach excretes a small amount of hydrochloric acid. This leads to a failure of separate vitamin B12 from food proteins, which inhibit vitamin B12 from absorption. In addition, the lack of secretion of hydrochloric acid provides a suitable environment for a reproduction of gut bacteria. These bacteria feed on vitamin B12, so it reduces the amount of vitamin B12. In the second stage of the normal body, vitamin B12 moves to the duodenum and combines with IF after releasing from proteins. Then it enters the small intestine up to the ileum (the last part of the small intestine) to break the IF, and absorb vitamin B12. However, in the second stage of pernicious anemia, the immune system becomes overactive. As a result, intrinsic factor antibodies form and attack IF and destroy them. This inhibits vitamin B12 from moving to the small intestine and absorption. The third stage in a normal body is, after absorbing vitamin B12, it is stored in the liver and bone marrow to manufacture erythrocytes. However, in the third stage of pernicious anemia, the amount of vitamin B12 is decreasing in the liver and bone marrow, which

The first cause is the failure of gastric parietal cells to manufacturing IF. This failure occurs when the parietal cells shrink in size (atrophy), then it leads to vitamin B12 deficiency, which reduces the number of erythrocytes, so directly it is lead to pernicious anemia. The second cause of pernicious anemia is atrophic gastritis which is a “chronic inflammation of the mucous stomach membrane that leading to losing the glandular cells that exist in the stomach.”[3] Then it converts to intestinal and fibrous tissue. As a result, the gastric becomes unable to secrete the basic materials such as hydrochloric acid, pepsin acid, and IF. Hydrochloric acid and IF are important to absorb vitamin B12. However, the patient who has atrophic gastritis cannot absorb vitamin B12, which is leading to vitamin B12 deficiency. The third cause is vitamin B9 deficiency (folic acid deficiency). Folic acid is important to the formation erythrocytes and reparation the damaging cells, so folic acid deficiency caused decreasing the number of healthy erythrocytes, which causes pernicious anemia. The last cause is bone marrow diseases. Because erythrocytes are synthesizing in bone marrow, so any diseases affect the bone marrow will affect erythrocytes, then they become unhealthy or abnormal. Then they will retain within the bone marrow, so