Pernicious anemia associated with autoimmune hemolytic anemia and alopecia areata

Zafad, S.; Madani, Abdellah; Harif, Mhamed; Quessar, Asmâa; Benchekroun, Saïd

doi:10.1002/pbc.20896

Cited by 11 publications

(9 citation statements)

References 4 publications

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“…AA has been associated with numerous comorbid immune-mediated diseases, and an association with PA would be reason for B 12 deficiency to be more prevalent in AA patients compared to controls. This principle is evidenced by a case-report [81] of a patient diagnosed with pernicious anemia at age 16 who later developed AA at age 24, and another report [73] of a patient who developed type 1 diabetes at age 18, 9 months later developed AA, and at age 27 was diagnosed with pernicious anemia. However, as mentioned previously, available case-control studies [72, 79, 80] with multiple AA cases did not identify any such differences in B 12 levels in patients compared to controls.…”

Section: Micronutrientsmentioning

confidence: 99%

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The Role of Micronutrients in Alopecia Areata: A Review

et al. 2017

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Alopecia areata (AA) is a common, non-scaring form of hair loss caused by immune-mediated attack of the hair follicle. As with other immune-mediated diseases, a complex interplay between environment and genetics is thought to lead to the development of AA. Deficiency of micronutrients such as vitamins and minerals may represent a modifiable risk factor associated with development of AA. Given their role in normal hair follicle development and in immune cell function, a growing number of investigations have sought to determine whether serum levels of these nutrients might differ in AA patients, and whether supplementation of these nutrients might represent a therapeutic option for AA. While current treatment often relies on invasive steroid injections or immunomodulating agents with potentially harmful side-effects, therapy by micronutrient supplementation, whether as a primary modality or as adjunctive treatment, could offer a promising low-risk alternative. However, our review highlights a need for further research in this area, given that the current body of literature largely consists of small case-control studies and case-reports which preclude any definite conclusions for a role of micronutrients in AA. In this comprehensive review of the current literature we found that serum vitamin D, zinc, and folate levels tend to be lower in patients with AA as compared to controls. Evidence is conflicting or insufficient to suggest differences in levels of iron, vitamin B12, copper, magnesium, or selenium. A small number of studies suggest that vitamin A levels may modify the disease. Though understanding of the role for micronutrients in AA is growing, definitive clinical recommendations such as routine serum level testing or therapeutic supplementation, call for additional studies in larger populations and with a prospective design.

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Section: Micronutrientsmentioning

confidence: 99%

“…At present, there are few studies (Table 5) [72, 73, 78–81] assessing B vitamin status in patients with AA. Yousefi et al [78] found lower RBC folate levels in 29 Iranian AA patients compared to controls.…”

Section: Micronutrientsmentioning

confidence: 99%

The Role of Micronutrients in Alopecia Areata: A Review

et al. 2017

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“…6,7,17,18 In one case of AIHA and B12 deficiency, related to metaplastic atrophic gastritis, successful treatment was achieved with steroids and vitamin B12. 6 In two other papers, failure to respond to B12 supplementation highlighted the AIHA diagnosis and necessity of steroid treatment, 7,17 while another patient responded to B12 therapy without resorting to steroids. 18 In all the described cases, both anti-PCA and anti-InF antibodies were positive.…”

Section: Discussionmentioning

confidence: 99%

Gastric neuroendocrine tumour, atrophic gastritis and autoimmune haemolytic anaemia: a case report and review

2019

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Gastric neuroendocrine tumours are rare. We describe a unique case of a 66-year-old male patient who presented with shortness of breath and malaise, eventually attributed to severe autoimmune haemolysis in the context of atrophic gastritis and multiple type-1 gastric neuroendocrine tumours. The patient had also positive anti-cardiolipin antibodies. A favourable outcome was attained with corticosteroids plus subtotal gastrectomy for the treatment of the underlying neoplastic disease. This case illustrates that the differential diagnosis of any associated causes of autoimmune haemolytic anaemia can be challenging, and may extend to unexpected conditions.

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“…PA with positive DAT status is associated with the appearance of hemolysis [ 1 , 7 – 9 ]. The autoantibody produced in PA patients may usually have non-specific reaction with erythrocyte.…”

Section: Discussionmentioning

confidence: 99%

“…The autoantibody produced in PA patients may usually have non-specific reaction with erythrocyte. However, in some cases, autoantibody affects hemolytic reaction to erythrocyte [ 7 , 8 ]; in which anemia will be persist with Vit.B12 treatment itself. PA has the status of ineffective erythropoiesis, where most of erythroblasts are dying in the intramedullary area by apoptosis, and release LDH [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

A case of pernicious anemia requiring differential diagnosis of autoimmune hemolytic anemia complication

Todo

Okamoto

Sugimoto

et al. 2017

Oxford Medical Case Reports

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An 80-year-old female was admitted to our hospital due to malaise. The initial diagnosis on admission was pernicious anemia (PA), Hashimoto thyroiditis and autoimmune atrophic gastritis. Autoimmune hemolytic anemia was suspected because direct antiglobulin test (DAT) was positive. Treatment with vitamin B12 improved anemia, with the disappearance of hemolysis. In some cases, PA patients with positive DAT may have hemolysis without the involvement of the autoimmune mechanism. Therefore, it is important to carefully assess PA patients with hemolysis and positive DAT for the prevention of unnecessary administration of steroid therapy.

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Pernicious anemia associated with autoimmune hemolytic anemia and alopecia areata

Cited by 11 publications

References 4 publications

The Role of Micronutrients in Alopecia Areata: A Review

The Role of Micronutrients in Alopecia Areata: A Review

Gastric neuroendocrine tumour, atrophic gastritis and autoimmune haemolytic anaemia: a case report and review

A case of pernicious anemia requiring differential diagnosis of autoimmune hemolytic anemia complication

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