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Anaemia is a condition where low levels of haemoglobin or red blood cells result in insufficient oxygen being carried to the organs and tissues. There are many causes of anaemia but the most common cause is iron deficiency. A lack of iron in the body can be due to poor diet (inadequate levels of iron, folic acid or vitamin B12[1]), heavy periods, pregnancy, peptic ulcers or non-steroidal anti-inflammatory drugs.

The symptoms of anaemia usually involve lethargy, shortness of breath, pale complexion, fatigue, weakness, cold hands and feet, headache, chest pain and brittle nails[2]. However in severe cases of anaemia patients can display symptoms including tachycardia (abnormally fast heartbeat) and heart failure[3]. There are several different types of anaemia such as sickle cell anaemia which is due to a genetic mutation involving glutamate and valine.

There are many forms of anaemia such as pernicious anaemia. Pernicious anaemia is when your body cannot absorb vitamin B12 from the food you eat, as your body attacks the cells in your stomach[4]. This is an auto-immune disease.

It is a complex disorder and consists of haematological, gastric and immunological alterations[5]. The inability to absorb B12 vitamins stems from lack of a protein called Intrinsic factor (IF) that is made in the stomach. The lack of IF occurs as a result of the activity of body immune's system that attacks and destroys cells that produce IF. There are also other factors that play a key role in b12 deficiency such as strict vegetarian diet, infections, surgery. Pernicious anemia is also called macrocytic anemia[6].. When there is a deficiency in B12 vitamin, the body produces abnormally large red blood cells called macrocytes. Due to such large size, macrocytes will not be able to leave bone marrow, where they are made, and enter the bloodstream. This decreases the amount of oxygen-carrying red blood cells in the bloodstream and can lead to fatigue and weakness.

PA is most common among those who are over 30, who live in Nothern Europe, especially Scandinavia and UK.


  1. Munker R, Hiller E, Glass J, Paquette R. (2007) Modern Hematology, 2nd edition, Totowa New Jersey: Humana Press
  3. Munker R, Hiller E, Glass J, Paquette R. (2007) Modern Hematology, 2nd edition, Totowa New Jersey: Humana Press
  5. N.Bizzaro, A.Antico. Diagnosis and classification of pernicious anaemia. Autoimmunity reviews 2014;vol13, issues 4-5, pages 565-568
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