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AHF Case Study

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Institution of Affiliation

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AHF Case Study

Q. 1 which condition might have placed this patient at a higher risk for PA

Autoimmune profiles carried out in individuals suffering from other autoimmune

disorders may reveal antibodies, which may be associated with PA, increasing the chances of

comorbidity in these patients (Osborne & SobczyńskaMalefora, 2015). Although no clear

guidelines are proposing PA screening in individuals suffering from other autoimmune disorders,

epidemiological research supports their coexistence with PA (Bizzaro & Antico, 2014). The

patient has a history of gastrectomy, a condition that might have placed her at a higher risk for

PA. Since PA is not a more complex deficit than a lack of intrinsic factors and the stomach being

the only source of this material, PA is expected to develop invariably following a gastrectomy.

Evidence demonstrates that PA occurs when the patient undergoes gastrectomy (Pritchard &

Hooper, 2016).

Q.2 briefly explain the underlying pathophysiology of pernicious anemia

The patient’s condition has occurred due to a limited quantity of vitamin B12 in the body.

Her gastrectomy history demonstrates that the absence of gastric intrinsic factor that enables

vitamin B12 absorption in the terminal ileum limits vitamin absorption. Vitamin B12 has a

critical role in cell division and nerve function in that its deficiency impacts the organ system,

such as the nervous system. The inadequate vitamins result in reduced generation of thymidine

synthase, which regulates cell division through DNA synthesis. Besides, limited vitamins result

in the development of the megaloblastic cells due to the reduced DNA synthesis. When the

megaloblastic red blood cells are not normal in shape, it limits their oxygen transportation

capacity, which explains the red tongue, fatigue, and hypoxemia (Toh, 2017).

Q.3 what is a potential non-reversible neurological complication of PA

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Anemia decreases the mass of red blood cells whose principal functions are delivering

oxygen to various tissues and carbon dioxide delivery to the lungs. Pernicious anemia

predisposes one to gastric adenocarcinoma as well as gastric carcinoid type-I. Therefore, in a

case whereby the pernicious anemia is not treated, the patient is at risk of suffering from these

(Pritchard & Hooper, 2016). Neurological complications can also be seen in untreated pernicious

anemia. These may include problems with vision, memory loss, and even ataxia. Infertility too

can arise if treatment is not administered to the patient. Finally, if the patient is pregnant, the

fetus becomes at risk of developing neural tube defects.

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References

Bizzaro, N., & Antico, A. (2014).Diagnosis and classification of pernicious anemia. Autoimmun

Rev, 13, (4-5).

Osborne, D., & Sobczyńska-Malefora, A. (2015).Autoimmune mechanisms in pernicious anemia

& thyroid disease. Autoimmun Rev, 14(9), 763-8.

Pritchard, D. M., & Hooper, M. (2016). Gastric cancer and pernicious anemia–only a minority of

UK pernicious anemia patients have had a gastroscopy. Alimentary pharmacology &

therapeutics, 43(10), 1106-1107.

Toh, B. H. (2017). Pathophysiology and laboratory diagnosis of pernicious anemia. Immunologic

research, 65(1), 326-330.