Abstract
A 12-year-old boy with pernicious anemia (PA) was reported. He was referred to our hospital because of a general malaise and pallor. The blood examination on admission revealed megaloblastic anemia (RBC 1.21 × 106/μl, Hb 4.7 g/dl, MCV 113.9 fl, MCH 39.2 pg) and neutropenia. Serum vitamin B12 was elevated, and the intrinsic factor antibody and parietal cell antibody were positive. A bone marrow smear showed metaplasia and megaloblastic changes in erythroid cells, and giant metamyelocytes and hypersegmented neutrophils were present. Atrophic gastritis was found by endoscopic examination. Results of a Schilling test with 57Co-intrinsic factor and 58Co were abnormally decreased (1.43 and 0.41%, respectively). Taken together, he was diagnosed as having McIntyre type II PA. He promptly recovered from anemia by vitamin B12 supplement. However, follow-up endoscopic gastrointestinal examinations are necessary because gastric cancer may occur in the presence of atrophic gastritis.
