Table of ContentsView AllTable of ContentsPernicious AnemiaMultiple Autoimmune ConditionsTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Pernicious Anemia
Multiple Autoimmune Conditions
Treatment
Frequently Asked Questions
Pernicious anemia(PA) is often thought of as a disease that older people get, but, actually, it can affect people of all ages. Research shows it is strongly associated with other autoimmune diseases, includingpsoriatic arthritis(PsA), a type ofinflammatory arthritisthat can affect people withpsoriasis(anautoimmune skin condition).
According to the Pernicious Anaemia Society, PA affects up to 4% of people with psoriatic arthritis.Symptoms of PsA include joint pain, stiffness, and swelling that flares up and subsides. PsA also causes lowred blood cell counts, which is a sign of anemia.
Keep reading to learn more about these two conditions, risk factors, treatment, and more.
What Is Pernicious Anemia?
The termanemiarefers to medical conditions in which the body can’t make enough healthy red blood cells to transport oxygen.
Intrinsic factor is needed to absorb dietaryvitamin B12in thesmall intestine.Vitamin B12 is an essential vitamin, and you need it to allow for proper red blood cell production and function, as well as to keep nerve cells healthy.
How Common Is Pernicious Anemia?PA is extremely rare, affecting about 0.1% of the general population and 1.9% of the population older than age 60.PA is also the reason for up to 50% of cases of vitamin B12 deficiency in adults.
How Common Is Pernicious Anemia?
PA is extremely rare, affecting about 0.1% of the general population and 1.9% of the population older than age 60.PA is also the reason for up to 50% of cases of vitamin B12 deficiency in adults.
The term “pernicious” means deadly, and this type of anemia is called pernicious because it was considered fatal in the past.These days, the condition is easily treatable with vitamin B12 supplementation—either in pill form or B12 injections. If PA is left untreated, though, it can lead to very severe complications, including neurological problems.
Symptoms
Pernicious anemia progresses slowly, which makes it harder to recognize. Most people get used to the symptoms and don’t realize there is a problem.
The most common symptoms of PA are:
Additional symptoms include appetite loss, heartburn, constipation, nausea, and vomiting.
Risk Factors for Pernicious Anemia
Some people have a higher risk for pernicious anemia.This includes those with a family history of the condition and people of Northern European or Scandinavian backgrounds.
Verywell / Laura Porter
Additional risk factors associated with PA include:
The autoimmune process that causes PA cannot be prevented. Vitamin B12 deficiency linked to other conditions (such as gastrointestinal diseases) is preventable to the extent those conditions also can be prevented.If vitamin B12 deficiency is related to diet, PA can be prevented with oral B12 supplements.
It is not uncommon for people to have more than one type ofautoimmune disease. In fact, people with PsA, psoriasis,rheumatoid arthritis(RA, which attacks the joints), and many other autoimmune diseases carry a higher risk of developing another autoimmune disease.
Although some conditions are more likely to coincide with another, the likelihood that someone with an autoimmune disease will develop another autoimmune disease is high.
Researchers believe autoimmune diseases co-occur for a variety of reasons. One theory is that when the immune system already has an autoimmunity issue, it is vulnerable and, therefore, open for another autoimmune disease to develop.
Genetic factors might contribute to the development of multiple autoimmune diseases, as well. Researchers believe that certain genetic and environmental factors can disrupt the immune system in a way that sets the stage for additional autoimmune disorders to progress.
According to the same report, other autoimmune conditions that occurred concurrently with PA included type 1 diabetes (in which the pancreas doesn’t make enough insulin, 35.9%),vitiligo(when the skin loses its pigment, 37.9%), andHashimoto’s thyroiditis(which damages the thyroid, 33.7%).
The risk for pernicious anemia in people with psoriatic arthritis isn’t clearly reported in literature. However, the risk for pernicious anemia associated with psoriasis appears to be high, at around 28%, according to the Pernicious Anaemia Society.
The research shows that psoriasis belongs to a group of disorders that tend to appear together and include both pernicious anemia and psoriasis. And according to the National Psoriasis Foundation, up to 33% of people who have psoriasis also have PsA, which further adds to their risk of pernicious anemia.
Multiple Autoimmune SyndromeWhen three or more autoimmune diseases occur in the same person, it is calledmultiple autoimmune syndrome. Oftentimes, at least one of these diseases is an autoimmune skin condition.
Multiple Autoimmune Syndrome
When three or more autoimmune diseases occur in the same person, it is calledmultiple autoimmune syndrome. Oftentimes, at least one of these diseases is an autoimmune skin condition.
Your doctor or a nurse can give you a vitamin B12 shot in a muscle. The injections are either given daily or weekly, depending on the severity of your PA.
Vitamin B12 oral supplements are rarely prescribed for PA as they don’t work as well as injections. A 2016 review in the journalFrontiers in Medicinefound them to be less effective than B12 shots.The study’s authors noted that many people might prefer taking oral supplements, however.
You may start to see improvements within a few days or weeks after you start treating your PA. Even after your B12 levels improve, your doctor may recommend you keep getting vitamin B12 injections on a monthly basis. At this point, you can self-administer shots at home or with the help of a family member to reduce your trips to the doctor.
In addition to treating the pernicious anemia, if your doctors can find an underlying cause, they will work to get that condition under control. This is generally the case when the body’s small intestine cannot properly absorb vitamin B12, as can happen with conditions likeceliac disease(an intolerance to the gluten found in wheat and other grains), Crohn’s disease, and other types ofinflammatory bowel disease (IBD).
If your B12 levels remain stable, your doctor might suggest supplements instead. However, depending on how deficient you are in intrinsic factor, you may be required to get B12 injections as a sole treatment for PA.
Pernicious anemia needs to be treated because it can lead to life-threatening complications without treatment. Talk to your doctor about your treatment options and how having PsA can contribute to complications of PA.
Summary
A Word From Verywell
Most people with pernicious anemia will need lifelong treatment with B12 injections or supplements. They will also need lifelong monitoring. These are the best ways to prevent long-term complications from PA.
Talk to your doctor if you think you are experiencing symptoms of pernicious anemia or symptoms that may be related to psoriatic arthritis. Early diagnosis, treatment, and monitoring are all vital for preventing future problems and complications of PA.
How do you treat pernicious anemia?
How is pernicious anemia diagnosed?
A diagnosis of pernicious anemia is based on your medical and family histories, a physical exam, and blood work. Doctors will also determine if your PA is related to a lack of intrinsic factor or if there is another cause. They will want to find out how severe that underlying condition is in order to treat it and get it under control.
If the diagnosis is uncertain, your doctor might suggest abone marrow test.Bone marrow testing can tell your doctor if your bone marrow is healthy and making enough red blood cells. With PA, the bone marrow cells that turn into blood cells are larger than normal.
What causes psoriatic arthritis flare-ups?
Just about everyone with psoriatic arthritis has flare-ups—periods where symptoms of the condition are worse than usual. Common PsA and psoriasis triggers include:
An Overview of Psoriatic Arthritis Triggers
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Li X, Thomsen H, Sundquist K, et al.Familial risks between pernicious anemia and other autoimmune diseases in the population of Sweden.Autoimmune Dis. 2021;2021:8815297. doi:10.1155/2021/8815297Pernicious Anaemia Society.Who is most at risk for pernicious anaemia?American College of Rheumatology.Psoriatic arthritis.MedlinePlus.Pernicious anemia.Office of Dietary Supplements.Vitamin B12 fact sheet for consumers.Andres E, Serraj K.Optimal management of pernicious anemia.J Blood Med. 2012;3:97-103. doi:10.2147/JBM.S25620National Heart, Lung, and Blood Institute.Vitamin B-12 deficient anemia.Castiblanco J, Sarmiento-Monroy JC, Mantilla RD, et al.Familial aggregation and segregation analysis in families presenting autoimmunity, polyautoimmunity, and multiple autoimmune syndrome.J Immunol Res. 2015;2015:572353. doi:10.1155/2015/572353Laisk T, Lepamets M, Koel M, Abner E; Estonian Biobank Research Team, Mägi R.Genome-wide association study identifies five risk loci for pernicious anemia.Nat Commun. 2021;12(1):3761. doi:10.1038/s41467-021-24051-6National Psoriasis Foundation.Related conditions of psoriasis.Lee SH, Kim YS, Kim HJ, Park YL.Psoriasis, vitiligo and Crohn’s disease co-existing in a single patient: A variant type of multiple autoimmune syndrome?Ann Dermatol. 2017;29(6):782-785. doi:10.5021/ad.2017.29.6.782Chan CQ, Low LL, Lee KH.Oral vitamin B12 replacement for the treatment of pernicious anemia.Front Med(Lausanne). 2016;3:38. doi:10.3389/fmed.2016.00038
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Li X, Thomsen H, Sundquist K, et al.Familial risks between pernicious anemia and other autoimmune diseases in the population of Sweden.Autoimmune Dis. 2021;2021:8815297. doi:10.1155/2021/8815297Pernicious Anaemia Society.Who is most at risk for pernicious anaemia?American College of Rheumatology.Psoriatic arthritis.MedlinePlus.Pernicious anemia.Office of Dietary Supplements.Vitamin B12 fact sheet for consumers.Andres E, Serraj K.Optimal management of pernicious anemia.J Blood Med. 2012;3:97-103. doi:10.2147/JBM.S25620National Heart, Lung, and Blood Institute.Vitamin B-12 deficient anemia.Castiblanco J, Sarmiento-Monroy JC, Mantilla RD, et al.Familial aggregation and segregation analysis in families presenting autoimmunity, polyautoimmunity, and multiple autoimmune syndrome.J Immunol Res. 2015;2015:572353. doi:10.1155/2015/572353Laisk T, Lepamets M, Koel M, Abner E; Estonian Biobank Research Team, Mägi R.Genome-wide association study identifies five risk loci for pernicious anemia.Nat Commun. 2021;12(1):3761. doi:10.1038/s41467-021-24051-6National Psoriasis Foundation.Related conditions of psoriasis.Lee SH, Kim YS, Kim HJ, Park YL.Psoriasis, vitiligo and Crohn’s disease co-existing in a single patient: A variant type of multiple autoimmune syndrome?Ann Dermatol. 2017;29(6):782-785. doi:10.5021/ad.2017.29.6.782Chan CQ, Low LL, Lee KH.Oral vitamin B12 replacement for the treatment of pernicious anemia.Front Med(Lausanne). 2016;3:38. doi:10.3389/fmed.2016.00038
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Li X, Thomsen H, Sundquist K, et al.Familial risks between pernicious anemia and other autoimmune diseases in the population of Sweden.Autoimmune Dis. 2021;2021:8815297. doi:10.1155/2021/8815297Pernicious Anaemia Society.Who is most at risk for pernicious anaemia?American College of Rheumatology.Psoriatic arthritis.MedlinePlus.Pernicious anemia.Office of Dietary Supplements.Vitamin B12 fact sheet for consumers.Andres E, Serraj K.Optimal management of pernicious anemia.J Blood Med. 2012;3:97-103. doi:10.2147/JBM.S25620National Heart, Lung, and Blood Institute.Vitamin B-12 deficient anemia.Castiblanco J, Sarmiento-Monroy JC, Mantilla RD, et al.Familial aggregation and segregation analysis in families presenting autoimmunity, polyautoimmunity, and multiple autoimmune syndrome.J Immunol Res. 2015;2015:572353. doi:10.1155/2015/572353Laisk T, Lepamets M, Koel M, Abner E; Estonian Biobank Research Team, Mägi R.Genome-wide association study identifies five risk loci for pernicious anemia.Nat Commun. 2021;12(1):3761. doi:10.1038/s41467-021-24051-6National Psoriasis Foundation.Related conditions of psoriasis.Lee SH, Kim YS, Kim HJ, Park YL.Psoriasis, vitiligo and Crohn’s disease co-existing in a single patient: A variant type of multiple autoimmune syndrome?Ann Dermatol. 2017;29(6):782-785. doi:10.5021/ad.2017.29.6.782Chan CQ, Low LL, Lee KH.Oral vitamin B12 replacement for the treatment of pernicious anemia.Front Med(Lausanne). 2016;3:38. doi:10.3389/fmed.2016.00038
Li X, Thomsen H, Sundquist K, et al.Familial risks between pernicious anemia and other autoimmune diseases in the population of Sweden.Autoimmune Dis. 2021;2021:8815297. doi:10.1155/2021/8815297
Pernicious Anaemia Society.Who is most at risk for pernicious anaemia?
American College of Rheumatology.Psoriatic arthritis.
MedlinePlus.Pernicious anemia.
Office of Dietary Supplements.Vitamin B12 fact sheet for consumers.
Andres E, Serraj K.Optimal management of pernicious anemia.J Blood Med. 2012;3:97-103. doi:10.2147/JBM.S25620
National Heart, Lung, and Blood Institute.Vitamin B-12 deficient anemia.
Castiblanco J, Sarmiento-Monroy JC, Mantilla RD, et al.Familial aggregation and segregation analysis in families presenting autoimmunity, polyautoimmunity, and multiple autoimmune syndrome.J Immunol Res. 2015;2015:572353. doi:10.1155/2015/572353
Laisk T, Lepamets M, Koel M, Abner E; Estonian Biobank Research Team, Mägi R.Genome-wide association study identifies five risk loci for pernicious anemia.Nat Commun. 2021;12(1):3761. doi:10.1038/s41467-021-24051-6
National Psoriasis Foundation.Related conditions of psoriasis.
Lee SH, Kim YS, Kim HJ, Park YL.Psoriasis, vitiligo and Crohn’s disease co-existing in a single patient: A variant type of multiple autoimmune syndrome?Ann Dermatol. 2017;29(6):782-785. doi:10.5021/ad.2017.29.6.782
Chan CQ, Low LL, Lee KH.Oral vitamin B12 replacement for the treatment of pernicious anemia.Front Med(Lausanne). 2016;3:38. doi:10.3389/fmed.2016.00038
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
