Symptoms of Pernicious anemia

List of symptoms of Pernicious anemia:

The list of signs and symptoms mentioned in various sources for Pernicious anemia includes the 34 symptoms listed below:

• Anemia - see also symptoms of anemia
  • Pallor
  • Tiredness
  • Fatigue
  • Shortness of breath
• Tongue symptoms
  • Burning tongue
  • Sore tongue
  • Red tongue
• Weight loss
• Loss of appetite
• Diarrhea
• Constipation
• Abdominal pain
• Paresthesias - abnormal tingling or burning sensations
  • Finger paresthesias
  • Pins and needles
  • Tingling fingers
  • Numb fingers
• Fever
• Malaise
• Unsteadiness
• Muscle spasms
• Movement disorders
• Spasticity
• Personality changes
• Weakness
• Fatigue
• Upset stomach
• Rapid heartbeat
• Chest pain
• Megaloblastic anemia
• Yellow skin
• Jaundice

Note that Pernicious anemia symptoms usually refers to various symptoms known to a patient, but the phrase Pernicious anemia signs may refer to those signs only noticable by a doctor.

More ways to research these symptoms: To research other symptoms use the symptom center, or to research causes of more than one symptom in combination, try our multi-symptom search.

Research More About Pernicious anemia

Do I have Pernicious anemia?

• Pernicious anemia: Introduction
• Pernicious anemia: Diagnostic Testing to confirm diagnosis
• Home Diagnostic Testing
• Alternative diagnoses and misdiagnosis for Pernicious anemia
• Hidden Causes of Pernicious anemia
• Treatments for Pernicious anemia
• More about Pernicious anemia

Home Diagnostic Testing

Home medical tests related to Pernicious anemia:

• Fatigue: Related Home Tests:
  • Home Anemia Tests
  • Home Thyroid Function Tests
  • Home Adrenal Function Tests
  • Home Calcium Deficiency Tests
  • Home HIV Tests
• Thyroid: Home Testing:
  • Home TSH Tests
  • Home Adrenal Function Tests
• Adrenal Gland Health: Home Testing:

Wrongly Diagnosed with Pernicious anemia?

The list of other diseases or medical conditions that may be on the differential diagnosis list of alternative diagnoses for Pernicious anemia includes:

• Iron deficiency anemia

See the full list of 1 alternative diagnoses for Pernicious anemia

More about symptoms of Pernicious anemia:

More information about symptoms of Pernicious anemia and related conditions:

• Other diseases with similar symptoms and common misdiagnoses
• Tests to determine if these are the symptoms of Pernicious anemia
• Symptoms that may be caused by complications of Pernicious anemia
• Underlying causes of Pernicious anemia
• Associated conditions for Pernicious anemia

Other Possible Causes of these Symptoms

Click on any of the symptoms below to see a full list of other causes including diseases, medical conditions, toxins, drug interactions, or drug side effect causes of that symptom.

• Abdominal pain - see all causes of Abdominal pain
• Anemia - see all causes of Anemia
• Burning tongue - see all causes of Sore tongue
• Chest pain - see all causes of Chest pain
• Constipation - see all causes of Constipation
• Diarrhea - see all causes of Diarrhea
• Fatigue - see all causes of Fatigue
• Fatigue - see all causes of Fatigue
• Fever - see all causes of Fever
• Finger paresthesias - see all causes of Finger paresthesia
• Jaundice - see all causes of Jaundice
• Loss of appetite - see all causes of Poor appetite
• Malaise - see all causes of Malaise
• Movement disorders - see all causes of Movement disorders
• Muscle spasms - see all causes of Muscle spasms
• Numb fingers - see all causes of Finger numbness
• Pallor - see all causes of Paleness
• Paresthesias - see all causes of Paresthesias
• Personality changes - see all causes of Personality change
• Pins and needles - see all causes of Tingling
• Rapid heartbeat - see all causes of Rapid heartbeat
• Red tongue - see all causes of Red tongue
• Shortness of breath - see all causes of Shortness of breath
• Sore tongue - see all causes of Sore tongue
• Spasticity - see all causes of Spasticity
• Tingling fingers - see all causes of Tingling fingers
• Tiredness - see all causes of Tiredness
• Tongue symptoms - see all causes of Tongue symptoms
• Unsteadiness - see all causes of Balance symptoms
• Upset stomach - see all causes of Upset stomach
• Weakness - see all causes of Weakness
• Weight loss - see all causes of Weight loss
• Yellow skin - see all causes of Yellow skin

Medical Books Online about Pernicious anemia

Medical Books Excerpts Excerpts of published medical book chapters related to Pernicious anemia are available from published medical books for more detailed information about Pernicious anemia.

Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

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Symptoms of Pernicious anemia: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the symptoms of Pernicious anemia.

Folic acid deficiency anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Folic acid deficiency anemia gradually produces clinical features characteristic of other megaloblastic anemias, without the neurologic manifestations: progressive fatigue, shortness of breath, palpitations, weakness, glossitis, nausea, anorexia, headache, fainting, irritability, forgetfulness, pallor, and slight jaundice. Folic acid deficiency anemia doesn’t cause neurologic impairment unless it’s associated with vitamin B₁₂ deficiency, as in pernicious anemia.

READ BOOK EXCERPT ONLINE »

Iron deficiency anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Because of the gradual progression of iron deficiency anemia, many patients are initially asymptomatic except for symptoms of any underlying condition. They tend not to seek medical treatment until anemia is severe. At advanced stages, decreased Hb levels and the consequent decrease in the blood’s oxygen-carrying capacity cause the patient to develop dyspnea on exertion, fatigue, listlessness, pallor, inability to concentrate, irritability, headache, and a susceptibility to infection. Decreased oxygen perfusion causes the heart to compensate with increased cardiac output and tachycardia.

In chronic iron deficiency anemia, nails become spoon-shaped and brittle, the mouth’s corners crack, the tongue turns smooth, and the patient complains of dysphagia or may develop pica. Associated neuromuscular effects include vasomotor disturbances, numbness and tingling of the extremities, and neuralgic pain.

READ BOOK EXCERPT ONLINE »

Sickle cell anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Characteristically, sickle cell anemia produces tachycardia, cardiomegaly, systolic and diastolic murmurs, pulmonary infarctions (which may result in cor pulmonale), chronic fatigue, unexplained dyspnea or dyspnea on exertion, hepatomegaly, jaundice, pallor, joint swelling, aching bones, chest pains, ischemic leg ulcers (especially around the ankles), and increased susceptibility to infection. Such symptoms usually don't develop until after age 6 months because large amounts of fetal Hb protect infants for the first few months after birth. Low socioeconomic status and related problems, such as poor nutrition and education, may delay diagnosis and supportive treatment.

Infection, stress, dehydration, and conditions that provoke hypoxia — strenuous exercise, high altitude, unpressurized aircraft, cold, and vasoconstrictive drugs —may all provoke periodic crises. A painful crisis (vasoocclusive crisis, infarctive crisis), the most common crisis and the hallmark of the disease, usually appears periodically after age 5. It results from blood vessel obstruction by rigid, tangled sickle cells, which causes tissue anoxia and possible necrosis. This type of crisis is characterized by severe abdominal, thoracic, muscular, or bone pain and possibly worsening jaundice, dark urine, and a low-grade fever.

Autosplenectomy, in which splenic damage and scarring is so extensive that the spleen shrinks and becomes impalpable, occurs in patients with long-term disease. This can lead to increased susceptibility to Streptococcus pneumoniae sepsis, which can be fatal without prompt treatment. Infection may develop after the crisis subsides (in 4 days to several weeks), so watch for lethargy, sleepiness, fever, or apathy.

An aplastic crisis (megaloblastic crisis) results from bone marrow depression and is associated with infection, usually viral. It's characterized by pallor, lethargy, sleepiness, dyspnea, possible coma, markedly decreased bone marrow activity, and RBC hemolysis.

In infants between ages 8 months and 2 years, an acute sequestration crisis may cause sudden massive entrapment of RBCs in the spleen and liver. This rare crisis causes lethargy and pallor and, if untreated, commonly progresses to hypovolemic shock and death.

A hemolytic crisis is quite rare and usually occurs in patients who also have glucose-6-phosphate dehydrogenase deficiency. It probably results from complications of sickle cell anemia, such as infection, rather than from the disorder itself. Hemolytic crisis causes liver congestion and hepatomegaly as a result of degenerative changes. It worsens chronic jaundice, although increased jaundice doesn't always point to a hemolytic crisis.

Suspect any of these crises in a sickle cell anemia patient with pale lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness with difficulty awakening; irritability; severe pain; a fever over 104° F (40° C); or a fever of 100° F (37.8° C) that persists for 2 days.

Sickle cell anemia also causes long-term complications. Typically, the child is small for his age and has delayed puberty. (However, fertility isn't impaired.) If he reaches adulthood, his body build tends to be spiderlike — narrow shoulders and hips, long extremities, curved spine, barrel chest, and elongated skull. An adult usually has complications from organ infarction, such as retinopathy and nephropathy. Premature death commonly results from infection or from repeated occlusion of small blood vessels and consequent infarction or necrosis of major organs (such as cerebral blood vessel occlusion causing stroke).

READ BOOK EXCERPT ONLINE »

Sideroblastic anemias: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Sideroblastic anemias usually produce nonspecific clinical effects, which may exist for several years before being identified. Such effects include anorexia, fatigue, weakness, dizziness, pale skin and mucous membranes and, occasionally, enlarged lymph nodes. Heart and liver failure may develop due to excessive iron accumulation in these organs, causing dyspnea, exertional angina, slight jaundice, and hepatosplenomegaly. Hereditary sideroblastic anemia is associated with increased GI absorption of iron, causing signs of hemosiderosis. Additional symptoms in secondary sideroblastic anemia depend upon the underlying cause.

READ BOOK EXCERPT ONLINE »

Pernicious anemia: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Characteristically, pernicious anemia has an insidious onset but eventually causes an unmistakable triad of symptoms: weakness, sore tongue, and numbness and tingling in the extremities. The lips, gums, and tongue appear markedly bloodless. Hemolysis-induced hyperbilirubinemia may cause faintly jaundiced sclera and pale to bright yellow skin. In addition, the patient may become highly susceptible to infection, especially of the genitourinary tract.

Other systemic symptoms of pernicious anemia include the following:

❑ GI: Gastric mucosal atrophy and decreased hydrochloric acid production disturb digestion and lead to nausea, vomiting, anorexia, weight loss, flatulence, diarrhea, and constipation. Gingival bleeding and tongue inflammation may hinder eating and intensify anorexia.

❑ Central nervous system (CNS): Demyelination caused by vitamin B₁₂ deficiency initially affects the peripheral nerves but gradually extends to the spinal cord. Consequently, the neurologic effects of pernicious anemia may include neuritis; weakness in extremities; peripheral numbness and paresthesia; disturbed position sense; lack of coordination; ataxia; impaired fine finger movement; positive Babinski’s and Romberg’s signs; light-headedness; altered vision (diplopia and blurred vision), taste, and hearing (tinnitus); optic muscle atrophy; loss of bowel and bladder control; and, in males, impotence. Its effects on the nervous system may also produce irritability, poor memory, headache, depression, and delirium. Although some of these symptoms are temporary, irreversible CNS changes may have occurred before treatment.

❑ Cardiovascular: Increasingly fragile cell membranes induce widespread destruction of RBCs, resulting in low Hb levels. The impaired oxygen-carrying capacity of the blood secondary to lowered Hb leads to weakness, fatigue, and light-headedness. Compensatory increased cardiac output results in palpitations, wide pulse pressure, dyspnea, orthopnea, tachycardia, premature beats and, eventually, heart failure.

❑ Musculoskeletal: Scissors gait can also occur as a late sign of untreated anemia.

READ BOOK EXCERPT ONLINE »

Aplastic anemias: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

Clinical features of aplastic anemias vary with the severity of pancytopenia but develop insidiously in many cases. Anemic symptoms include progressive weakness and fatigue, shortness of breath, headache, pallor and, ultimately, tachycardia and heart failure. Thrombocytopenia leads to ecchymosis, petechiae, and hemorrhage, especially from the mucous membranes (nose, gums, rectum, and vagina) or into the retina or central nervous system. Neutropenia may lead to infection (fever, oral and rectal ulcers, and sore throat) but without characteristic inflammation.

READ BOOK EXCERPT ONLINE »

Chronic fatigue syndrome: Signs and symptoms
(Professional Guide to Diseases (Eighth Edition))

CFS has specific symptoms and signs, based on the exclusion of other possible causes. Its characteristic symptom is prolonged, often overwhelming fatigue that’s commonly associated with a varying complex of other symptoms that are similar to those of many infections, including myalgia and cephalgia. It may develop within a few hours and can last for 6 months or more. Fatigue isn’t relieved by rest and is severe enough to restrict activities of daily living by at least 50%. To aid in disease identification, the Centers for Disease Control and Prevention (CDC) uses a “working case definition” to group symptoms and severity.

READ BOOK EXCERPT ONLINE »

Folic acid deficiency anemia: Signs and symptoms
(Handbook of Diseases)

Folic acid deficiency anemia gradually produces clinical features that are characteristic of other megaloblastic anemias without the neurologic manifestations. These include progressive fatigue, dyspnea, palpitations, weakness, glossitis, nausea, anorexia, headache, fainting, irritability, forgetfulness, pallor, and slight jaundice.

Folic acid deficiency anemia doesn’t cause neurologic impairment unless it’s associated with vitamin B₁₂ deficiency, as in pernicious anemia.

READ BOOK EXCERPT ONLINE »

Iron deficiency anemia: Signs and symptoms
(Handbook of Diseases)

Because of the gradual progression of iron deficiency anemia, many patients are initially asymptomatic. They tend not to seek medical treatment until anemia is severe.

At advanced stages, a decreased Hb level and the consequent decrease in the blood’s oxygen-carrying capacity cause the patient to develop exertional dyspnea, fatigue, listlessness, pallor, inability to concentrate, irritability, headache, and a susceptibility to infection. Decreased oxygen perfusion causes the heart to compensate with increased cardiac output and tachycardia.

With chronic iron deficiency anemia, nails become spoon shaped and brittle, the corners of the mouth crack, the tongue turns smooth, and the patient complains of dysphagia or may develop pica. Associated neuromuscular effects include vasomotor disturbances, numbness and tingling of the extremities, and neuralgic pain.

READ BOOK EXCERPT ONLINE »

Sickle cell anemia: Signs and symptoms
(Handbook of Diseases)

Characteristically, sickle cell anemia produces tachycardia, cardiomegaly, systolic and diastolic murmurs, pulmonary infarctions (which may result in cor pulmonale), chronic fatigue, unexplained dyspnea or dyspnea on exertion, hepatomegaly, jaundice, pallor, joint swelling, aching bones, chest pains, ischemic leg ulcers (especially around the ankles), and increased susceptibility to infection.

Such symptoms usually don’t develop until after age 6 months, because large amounts of fetal Hb protect infants for the first few months after birth. Low socioeconomic status and related problems, such as poor nutrition and education, may delay diagnosis and supportive treatment.

Infection, stress, dehydration, and conditions that provoke hypoxia —  strenuous exercise, high altitude, unpressurized aircraft, cold, and vasoconstrictive drugs — may all provoke periodic crisis. Four types of crises can occur: painful, aplastic, acute sequestration, or hemolytic.

Painful crisis

Also called a vaso-occlusive crisis or infarctive crisis, painful crisis is the most common crisis and the hallmark of this disease. It usually appears periodically after age 5.

A painful crisis results from blood vessel obstruction by rigid, tangled sickle cells, which causes tissue anoxia and possible necrosis. It’s characterized by severe abdominal, thoracic, muscular, or bone pain and, possibly, increased jaundice, dark urine, or a low-grade fever.

UNDER STUDY:  In pediatric patients with vaso-occlusive crisis, 1-arginine, a precursor to nitric oxide, has been found to be diminished. In adults, it has been significantly diminished in 50% of patients administered to the emergency department with vaso-occlusive crisis.

Autosplenectomy, in which splenic damage and scarring is so extensive that the spleen shrinks and becomes impalpable, occurs in patients with long-term disease. This can lead to increased susceptibility to Streptococcus pneumoniae sepsis, which can be fatal without prompt treatment.

After the crisis subsides (in 4 days to several weeks), infection may develop, causing such signs as lethargy, sleepiness, fever, and apathy.

Aplastic crisis

Also called megaloblastic crisis, aplastic crisis results from bone marrow depression and is associated with infection, usually viral. It’s characterized by pallor, lethargy, sleepiness, dyspnea, possible coma, markedly decreased bone marrow activity, and RBC hemolysis.

Acute sequestration crisis

In infants between 8 months and 2 years old, an acute sequestration crisis may cause sudden massive entrapment of RBCs in the spleen and liver. This rare crisis causes lethargy and pallor; if untreated, it commonly progresses to hypovolemic shock and death.

Hemolytic crisis

Quite rare, hemolytic crisis usually occurs in patients who have glucose-6-phosphate dehydrogenase deficiency with sickle cell anemia. It probably results from complications of sickle cell anemia, such as infection, rather than from the disorder itself.

Hemolytic crisis causes liver congestion and hepatomegaly as a result of degenerative changes. It worsens chronic jaundice, although increased jaundice doesn’t always point to a hemolytic crisis.

Indicators of crisis

Suspect any of these crises in a sickle cell anemia patient with pale lips, tongue, palms, or nail beds; lethargy; listlessness; sleepiness, with difficulty awakening; irritability; severe pain; temperature over 104° F (40° C); or a fever of 100° F (37.8° C) that persists for 2 days.

Long-term complications

Sickle cell anemia also causes long-term complications. Typically, such a child is small for his age, and puberty is delayed. (However, fertility isn’t impaired). If he reaches adulthood, his body build tends to be spiderlike — narrow shoulders and hips, long extremities, curved spine, barrel chest, and elongated skull.

An adult usually has complications with organ infarction, such as retinopathy and nephropathy. Premature death commonly results from infection or repeated occlusion of small blood vessels and consequent infarction or necrosis of major organs. For example, cerebral blood vessel occlusion causes cerebrovascular accident.

READ BOOK EXCERPT ONLINE »

Sideroblastic anemias: Signs and symptoms
(Handbook of Diseases)

Sideroblastic anemias usually produce nonspecific clinical effects, which may exist for several years before being identified. Such effects include anorexia, fatigue, weakness, dizziness, pale skin and mucous membranes and, occasionally, enlarged lymph nodes.

Heart and liver failure may develop from excessive iron accumulation in these organs, causing dyspnea, exertional angina, slight jaundice, and hepatosplenomegaly. Hereditary sideroblastic anemia is associated with increased GI absorption of iron, causing signs of hemosiderosis. Additional symptoms in secondary sideroblastic anemia depend on the underlying cause.

READ BOOK EXCERPT ONLINE »

Pernicious anemia: Signs and symptoms
(Handbook of Diseases)

Characteristically, pernicious anemia has an insidious onset but eventually causes an unmistakable triad of symptoms: weakness, sore tongue, and numbness and tingling in the extremities. The lips, gums, and tongue appear markedly bloodless. Hemolysis-induced hyperbilirubinemia may cause faintly jaundiced sclera and pale to bright yellow skin. The patient may also become highly susceptible to infection, especially of the genitourinary tract.

GI signs and symptoms

Gastric mucosal atrophy and decreased hydrochloric acid production disturb digestion and lead to nausea, vomiting, anorexia, weight loss, flatulence, diarrhea, and constipation. Gingival bleeding and tongue inflammation may hinder eating and intensify anorexia.

Central nervous system signs and symptoms

Nerve demyelination caused by vitamin B₁₂ deficiency initially affects the peripheral nerves but gradually extends to the spinal cord. Consequently, the neurologic effects of pernicious anemia include neuritis, weakness in the extremities, peripheral numbness and paresthesia, disturbed position sense, lack of coordination, ataxia, impaired fine finger movement, positive Babinski’s and Romberg’s signs, light-headedness, optic muscle atrophy, loss of bowel and bladder control, impotence (in males), and altered vision (diplopia, blurred vision), taste, and hearing (tinnitus).

The effects of pernicious anemia on the nervous system may also produce irritability, poor memory, headache, depression, and delirium. Although some of these symptoms are temporary, irreversible central nervous system changes may have occurred before treatment is initiated.

Cardiovascular signs and symptoms

Increasingly fragile cell membranes induce widespread destruction of RBCs, resulting in low hemoglobin (Hb) levels. The impaired oxygen-carrying capacity of the blood secondary to lowered Hb leads to weakness, fatigue, and light-headedness. Compensatory increased cardiac output results in palpitations, wide pulse pressure, dyspnea, orthopnea, tachycardia, premature beats and, eventually, heart failure.

READ BOOK EXCERPT ONLINE »

Aplastic and hypoplastic anemias: Signs and symptoms
(Handbook of Diseases)

Signs and symptoms of aplastic anemias vary with the severity of pancytopenia but usually develop insidiously. These include progressive weakness and fatigue, shortness of breath, headache, pallor and, ultimately, tachycardia and heart failure. Thrombocytopenia leads to ecchymosis, petechiae, and hemorrhage, especially from the mucous membranes (nose, gums, rectum, and vagina) or into the retina or central nervous system. Neutropenia may lead to infection (with fever, oral and rectal ulcers, and sore throat) but without characteristic inflammation.

READ BOOK EXCERPT ONLINE »

Chronic fatigue and immune dysfunction syndrome: Signs and symptoms
(Handbook of Diseases)

The characteristic symptom of CFIDS is prolonged, often overwhelming fatigue that’s commonly associated with a varying complex of other symptoms. To aid identification of the disease, the Centers for Disease Control and Prevention (CDC) uses a “working case definition” to group symptoms and severity. (See CDC criteria for diagnosing CFIDS.)

READ BOOK EXCERPT ONLINE »

Pernicious anemia as a Cause of Symptoms or Medical Conditions

When considering symptoms of Pernicious anemia, it is also important to consider Pernicious anemia as a possible cause of other medical conditions. The Disease Database lists the following medical conditions that Pernicious anemia may cause:

• Brain failure
• Cabot's ring body
• Diarrhoea
• Glossitis
• Hypergastrinaemia
• Hypochlorhydria
• Ineffective erythropoiesis
• Peripheral neuropathy
• Sensory ataxia
• Subacute combined degeneration of the cord
• Upper motor neurone lesion
• Vitamin B12 deficiency

Pernicious anemia as a symptom:

For a more detailed analysis of Pernicious anemia as a symptom, including causes, drug side effect causes, and drug interaction causes, please see our Symptom Center information for Pernicious anemia.

Medical articles and books on symptoms:

These general reference articles may be of interest in relation to medical signs and symptoms of disease in general:

• Diagnostic Testing for a Diagnosis of Pernicious anemia
• Research Alternative Diagnoses for Pernicious anemia
• More about Pernicious anemia
• Online Diagnosis
• Self Diagnosis Pitfalls
• Pitfalls of Online Diagnosis
• Symptoms of the Silent Killer Diseases
• Lesser known silent killer diseases
• Books on signs and symptoms

Full list of premium articles on symptoms and diagnosis

About signs and symptoms of Pernicious anemia:

The symptom information on this page attempts to provide a list of some possible signs and symptoms of Pernicious anemia. This signs and symptoms information for Pernicious anemia has been gathered from various sources, may not be fully accurate, and may not be the full list of Pernicious anemia signs or Pernicious anemia symptoms. Furthermore, signs and symptoms of Pernicious anemia may vary on an individual basis for each patient. Only your doctor can provide adequate diagnosis of any signs or symptoms and whether they are indeed Pernicious anemia symptoms.