Introduction
Some types of anemia develop later than others, and their diagnosis may rely on one specific sign and additional examination. In the selected case, the 67-year-old female presents with a red and swollen tongue, weight loss, and overall weakness. The diagnostics and the patient’s symptoms are an example of an autoimmune disorder – pernicious anemia.
Differentiating Pernicious Anemia from Other Types of Disorder
Pernicious anemia is a condition that may be challenging to diagnose before clear signs appear. This megaloblastic anemia develops after 60, especially in people of North European descent (McCance & Huether, 2019). The main symptom is a swollen, “beef red” tongue.
Furthermore, laboratory findings show low hemoglobin, hematocrit, reticulocyte count, and serum B12 (McCance & Huether, 2019). In contrast, one may find a high concentration of ferritin, plasma iron, and bilirubin and an elevated mean corpuscular volume (McCance & Huether, 2019). Pernicious anemia results from the lack of intrinsic factor that usually transports B12 in the small intestine (Nagalia, 2019). Without it, the immune system creates antibodies that damage gastric cells.
Other types of anemia present with different clinical findings and symptoms. For example, another megaloblastic anemia type is caused by folate deficiency. The absence of folic acid in the body results in impaired synthesis of DNA and megaloblastic cells, which leads to malnourishment and ulcerations. Diagnostic tests usually show numbers similar to pernicious anemia but with a normal level of serum B12 and a decreased volume of folate (McCance & Huether, 2019).
Among microcytic anemias, iron deficiency is the most common type (McCance & Huether, 2019). It develops when a person does not get enough iron, which leads to the production of small, deficient cells with low hemoglobin (McCance & Huether, 2019). Diagnostics may reveal low hemoglobin, hematocrit, mean corpuscular volume, plasma iron, and ferritin (McCance & Huether, 2019).
There are no specific racial or ethnic variables that contribute to iron or folate deficiency. However, black impoverished females are among the most vulnerable groups for iron deficiency anemia due to their poor diet (McCance & Huether, 2019). Thus, socioeconomic characteristics are also important factors that impact these conditions.
Conclusion
In conclusion, anemias can develop at various stages in life and result from genetic factors or lifestyle choices. Cells may become megaloblastic or microcytic and hypochromic, depending on the type. Pernicious anemia is distinguished by its presentation, later onset, and diagnostics. Similarly, laboratory testing is necessary to identify the specific anemia.
References
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby/Elsevier.
Nagalia, S. (2019). Pernicious anemia. Medscape.