BMJ Case Reports 2012; doi:10.1136/bcr.01.2012.5576
  • Unusual association of diseases/symptoms

Autoimmune pernicious anaemia as a cause of collapse, heart failure and marked panyctopaenia in a young patient

  1. Ebru Hack2
  1. 1Department of Infectious Diseases, Fremantle Hospital and Health Service, Fremantle, Western Australia, Australia
  2. 2Department of Acute Medicine, Princess Alexandra Hospital, Harlow, UK
  1. Correspondence to Dr Justin Carey, drjustincarey{at}


A 35-year-old woman with a history of vitiligo, hypothyroidism and amenorrhoea presented with collapse and clinical features of cardiac failure. Laboratory investigations revealed pancytopaenia, the cause of which was found to be vitamin B12 deficiency due to pernicious anaemia. Treatment with intramuscular hydroxycobalamin was commenced and the patient improved steadily with concomitant improvement in her haematological indices. Clinical features of pernicious anaemia which can include marked pancytopaenia, diagnostic approach, associated conditions and approach to treatment are discussed. The importance of surveillance for gastrointestinal malignancy is emphasised.


  • Competing interests None.

  • Patient consent Obtained.

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