A case of pernicious anemia of 55 year-old married, Korean male farmer is presented
and the literatures for the case are briefly reviewed.
The farmer was admitted to the department of Internal Medicine of Seoul National
University Hospital on June 25th, 1971, because of general weakness, dizziness, anorexia
and indigestion since January, 1970.
On physical examinations his general appearance showed flabby pallor and yellowish
color of the skin. There was moderate alopecia and slight impairment of memory. His
hair was brown in color, thin and nonlustered. Conjunctiva was markedly anemic and
sclera was slightly icteric. Moderate hepatomegaly and slight splenomegaly were noted.
There was mild tenderness on the epigastrium and right upper quadrant.
Neurological examination was negative.
On the laboratory examination, the peripheral blood smears disclosed marked
pancytopenia, macrocytosis and basophilic stippling. The bone marrow showed
normoblastic hyperplasia, most of which were megaloblastoid, and histamine resistant
achlorhydria was noted.
The Schilling test revealed a 24 hour urinary excretion of 0.66% (normal range:
7-22%) and biopsies liver tissue disclosed severe transfusional hemosiderosis.
Frank reticulocytic response to the therapeutic trial was observed with a peak on the
4th day after the parenteral administration of Vitamin B12.
Continuous increase in number of RBC, Hb and platelet count was noted since the
therapeutic trials together with improvement cf general physical condition. On 25th day
after beginning of the therapy the bone marrow returned to almost normal findings.
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