Addison-Biermer disease

Addison-Biermer diseaseDescription, Causes and Risk Factors:Addison-Biermer disease is a disorder in vitamin B12 absorptin characterized of megaloblastic anemia and gastrointestinal symptoms, and that can lead to neurological abnormalities. The prevelance is estimated at 1/769 and the incidence at around 1/11,000. Although frequent in the elderly (>60 years old), Addison-Biermer disease is less common in adults (15% of cases) and is extremely rare in children and adolescents.Addison-Biermer diseaseThe disease can remain asymptomatic for years or manifest with nonspecific symptoms of anemia (e.g. fatigue, asthenia, headache). Addison-Biermer disease is frequently associated with atrophic gastritis. Dyspepsia, postprandial bloating, and glossitis may be present. Neurological problems can be observed, such as ataxia, spasticity or signs of peripheral neuropathy (e.g. gait abnormalities), and sometimes cognitive decline in adolescents. Addison-Biermer disease is frequently associated with autoimmune diseases (autoimmune thyroid disease, idiopathic hypoparathyroidism, type 1 diabetes) as part of autoimmune polyendocrinopathy type 2 and vitiligo. In the rare cases appearing in the newborn period, Addison-Biermer disease manifests with failure to thrive, developmental delay, anorexia, irritability, and ultimately macrocytic anemia.Risk Factors May Include:• Age over 40.• Stomach surgery, stomach cancer, or gastritis.• Diabetes and autoimmune disorders.• Myxedema, Graves' disease, or other thyroid disorders.• Genetic factors, such as in people of Northern European ancestry. It is rare in blacks and Asians.• Family history of pernicious anemia.• Strict vegetarian diet or infants breast-fed by a mother on a strict vegetarian diet.• Lack of stomach acid in older adults.• Parasitic infections and intestinal diseases.• Some drugs such as H2 blockers, proton pump inhibitors, colchicine, neomycin, and aminosalicylic acid.• Alcoholism.If untreated, neurological damage may occur such as peripheral neuropathy, subacute combined degeneration of the spinal cord and/or ataxia. Cases of Addison-Biermer disease during the periconceptual period of maternal origin have also been observed, in which fetuses have neural tube defects like spina bifida (embryologic failure of fusion of one or more vertebral arches; subtypes of spina bifida are based on degree and pattern of malformation associated with neuroectoderm involvement).Symptoms:Symptoms may include the following:Weakness, especially in the arms and legs.
  • Sore tongue.
  • Nausea, appetite loss, and weight loss.
  • Numbness or tingling in the hands and feet.
  • Difficulty maintaining proper balance.
  • Pale lips, tongue, and gums.
  • Yellow eyes and skin.
  • Bleeding gums.
  • Shortness of breath.
  • Depression, confusion, poor memory, and dementia.
  • Headache.
  • Ringing in the ears (tinnitus).
Diagnosis:Differential diagnosis includes congenital intrinsic factor deficiency, Imerslund-Gr

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