Introduction
The term anemia, as used in medicine, refers to the decrease in the amount of erythrocytes (human red blood cells) of the amount of protein iron-rich oxygen transport protein hemoglobin in the body. In mammals, red blood cells (RBCs) play a significant role in transporting oxygen from the entry points (alveolus of the lungs) to other cells to maintain normal metabolism. In general, the onset of the anemia symptoms is slow and often vague. The patients experience tiredness, shortness of breath, general weakness and reduced ability to exercise. Different factors contribute to the development of anemia, which results into a number of different types of anemia (Janz, Johnson & Rubenstein, 2013, p. 11). Studies indicate that Pernicious anemia and iron-deficiency anemia are the most common types of the condition. This paper compares pernicious anemia and iron-deficiency anemia to examine the impacts of patient factors on the onset and development.
Differences and similarities between Pernicious anemia and Iron-deficient anemia
Causes
A number of factors that may lead to insufficiency of a certain product in the body system cause both iron-deficiency anemia and pernicious anemia. In iron-deficiency anemia, insufficient intake and absorption of dietary iron and excessive loss of iron due to a number of factors cause the condition (Huether & MacCance, 2012, p. 126). Similarly, lack of vitamin B12 leads to pernicious anemia due to insufficient intake and absorption of dietary vitamin (Kumar, 2012, p. 31). It is also worth noting that gastric ulcers and gastrointestinal cancers contribute to both pernicious and iron-deficiency anemia.
Nevertheless, excessive loss of B12 has not been shown to be a cause of the problem, unlike in the cases of iron-deficiency anemia. In addition, factors such as infection with parasitic worms (hookworms, roundworms and whipworms) contribute to the development of iron-deficiency anemia in children.
Pathophysiological mechanism
The mechanism of developing pernicious anemia is relatively different from the mechanism involved in the pathophysiology of iron-deficient anemia. In iron-deficient anemia, advanced-stage iron deficiency is the mechanism behind the disease. Ferritin complexes of iron resources are depleted and the intestinal cells are unable to absorb iron from the diet.
Pernicious anemia results from a relatively different pathological mechanism. Human bodies require vitamin B12 in the process of making red blood cells in their bone marrows. Vitamin B12 is primarily derived from the diet, especially those rich in animal products (Moridani & Shana, 2010, p. 168). For the intestinal cells to absorb this form of vitamin, Intrinsic Factor (IF) protein is involved (Madhaiyan, Sridhar, Sundarrajan, Venugopal & Ramakrishna, 2013, p. 72). Lack of this factor, which is released from the stomach cells, leads to deficiency of vitamin B12, eventually causing anemia (Kumar, 2012, p. 30).
How do Patient factors affect the disorders?
Existence of pathological conditions
Both pernicious and iron-deficiency anemia results from a number of factors associated. For instance, most patients with weakened lining of the stomach due to atrophic gastritis are likely to develop both forms of anemia because the weakened lining does not produce enough IF (pernicious). However, in pernicious anemia, patients with autoimmune conditions that causes the body’s immune system to attack the IF protein or the cells in the stomach lining normally leads to pernicious anemia due to a deficiency of vitamin B12.
Genetics
Unlike the case of iron-deficiency anemia, genetics play an important role in the development of pernicious anemia in some cases. For instance, congenital pernicious anemia is common in families and runs from one generation to another. The onset of the congenital pernicious anemia is seen early in life, especially during infancy (Masnou, Domènech, Navarro-Llavat, et al, 2011, p. 581). Such infants fail to make enough IF protein or fail to absorb vitamin B12 in the required amounts, leading to anemia.
Age
Age is a determining factor in the development of both forms of anemia. For instance, below the age of 30, it is not common to detect the disease in most cases. In fact, most patients develop the disease by the age of 60. Studies have shown that the average age of diagnosis for the condition is about 55 to 60 years (Desai & Gupte, 2012, p. 861). On the other hand, iron-deficiency anemia is common in children under the age of five years, especially those infected with parasitic worms.
Behavior factors
Individuals who are strict vegetarians are under the risk of developing pernicious anemia because they fail to consume foods rich in vitamin B12, which is derived primarily from animal products. On the other hand, individuals who fail to consumer foods rich in iron are under the risk of developing iron-deficiency anemia.
Ethnicity/Race
According to studies, ethnicity is an important patient factor that tends to determine the likelihood of developing pernicious anemia, which is not common in iron-deficiency anemia. For instance, individuals of Scandinavian or northern European ancestry have the highest chance of developing the diseases compared to other groups. In these cases, individuals from these two ancestries tend to inherit the condition from their families, providing evidence of genetic and evolutionary factors.
Disease states
It is also worth noting that a number of diseases tend to raise the risk of developing both forms of anemia. For instance, individuals with Addison disease, Graves’ disease, type-1 diabetes, vitiligo, chronic thyroiditis and other conditions are likely to develop pernicious anemia. A number of studies have also shown that Helicobacter pylori is a major risk factor in developing pernicious anemia (Desai & Gupte, 2012, p. 859).
Gender
Pregnant women have a high risk of developing iron-deficiency anemia, especially those infected with worms and malaria. On the other hand, pernicious anemia does not depend on gender, which means that both males and females have equal chances of developing the condition.
References
Desai, H. G., & Gupte, P. A. (2012). Helicobacter pylori link to pernicious anemia. The Journal of the Association of Physicians of India 55(2), 857–9.
Huether, S. E., & MacCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed,). St, Louis, MO: Mosby.
Janz, T., Johnson, R. L., & Rubenstein, S. D. (2013). Anemia in the emergency department: evaluation and treatment. Emergency medicine practice 15(11), 1–15.
Kumar, V. (2012). Pernicious anemia. MLO, 39(2), 28, 30–1.
Madhaiyan, K., Sridhar, R., Sundarrajan, S., Venugopal, JR., & Ramakrishna, S. (2013). Vitamin B12 loaded polycaprolactone nanofibers: A novel transdermal route for the water soluble energy supplement delivery. International Journal of Pharmaceutics, 444(1–2), 70–7.
Masnou, H., Domènech, E., Navarro-Llavat, M., et al. (2011). Pernicious anaemia in triplets. A case report and literature review. GastroenterologĂa y HepatologĂa 30(10), 580–2.
Moridani, M., & Shana, B. (2010). Laboratory Investigation of Vitamin B12 Deficiency. LabMedicine 37(3), 166–74.