World Journal of
Pharmaceutical and Life Sciences

UNMASKING PERNICIOUS ANEMIA: CLINICAL DIVERSITY AND AUTOIMMUNE OVERLAP IN A NORTH AFRICAN POPULATION

Youssef Alhonsali*, Mohamed Borahma, Fatima-Zahra Chabib, Nawal Lagdali, Fatima-Zahra Ajana, Maryeme Kadiri

ABSTRACT

Background: Pernicious anemia (PA) is a complex autoimmune disorder caused by chronic atrophic gastritis leading to intrinsic factor deficiency and then to vitamin B12 deficiency. By the huge heterogenicity of symptoms, PA can be misdiagnosed. This pathology is also challenging by her association with many other auto-immune diseases. Methods: We conducted a retrospective observational study including 46 patients diagnosed with PA between 2018 and 2024 at a Moroccan university center. Was included patient with confirm PA diagnosis. This diagnosis was established based on: clinical manifestations, biochemical evidence of vitamin B12 deficiency, positive serological markers (anti-parietal cell and/or anti-intrinsic factor antibodies), and essentially endoscopic/histological confirmation of gastric atrophy. Results: The 46 patients had a mean age of 56.2 ± 12.3 years, with a female predominance (F/M ratio = 1.8). Anemia was present in all cases, with macrocytic morphology in 37%, microcytic in 27%, and normocytic in 29%. Neurological manifestations occurred in 19.6% of patients, most frequently peripheral neuropathy (17%). Autoimmune comorbidities were identified in 32.6%, mainly autoimmune thyroiditis (33% of cases) and primary biliary cholangitis (20%). Vitamin B12 supplementation achieved hematological normalization in 95% of patients, although two developed neoplastic complications during follow-up. Conclusion: diagnosing PA can by extremely complexed, our study highlight the importance of evaluation beyond classical macrocytic anemia to bring the right diagnostic. Systematic screening seems to by indispensable since PA comes with high prevalence of associated autoimmune disorders. Our findings align with recent international literature while providing unique insights from a North African population.

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