Pernicious Anaemia and Polycythaemia Vera

Ellman, Philip; Bowdler, A. J.

doi:10.1136/pgmj.34.398.638

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…Exceptionally, as occurred in our patient, vitamin-B12 deficiency may develop' in an individual with a propensity towards myeloproliferative disease, but the number of reported instances of this combination of blood disorders is small. The occurrence of polycythaemia vera and pernicious anaemia in the same patient has been reported by Birnie (1936), Ferrary (1942), Galt et al (1952), Skouby (1952), Hinz (1957, and Ellman and Bowdler (1958). Other likely instances of this phenomenon are reported by Avery (1930) and by Emile Weil and Boic (1932).…”

Section: Discussionsupporting

confidence: 55%

“…However, the occurrence of both diseases in the one patient renders this an untenable concept; in the case reported by Ellman and Bowdler (1958) it was proved that added intrinsic factor was needed to increase absorption of orally administered radioactive vitamin B12* As our patient was unwilling to be admitted to hospital it was impossible to use this technique or to carry out fat-balance studies. There was no obvious clinical evidence to suggest steatorrhoea ; the serum vitamin-B12 value was low after a period of no therapy: there was histamine-fast achlorhydria; and the haematological response to small doses of parenteral vitamin B12 was dramatic.…”

Section: Discussionmentioning

confidence: 88%

“…However, as is stated by Ellman and Bowdler (1958), this appears only rarely as a mild non-progressive erythrocytosis, and it is widely held that generous doses of liver or vitamin B12 do not raise blood-count values of normal subjects or patients with pernicious anaemia above physiological limits. Exceptionally, as occurred in our patient, vitamin-B12 deficiency may develop' in an individual with a propensity towards myeloproliferative disease, but the number of reported instances of this combination of blood disorders is small.…”

Section: Discussionmentioning

confidence: 96%

“…It is of interest to note that Sir William Osler (1903) in his classical paper on polycythaemia mentions a patient who was " as red as a beet " and suspected of having polycythaemia vera, but who had had, in fact, blood-count changes resembling pernicious anaemia. The most recent accounts of the association of pernicious anaemia and polycythaemia vera in the same patient are those of Hinz (1957) and Eliman and Bowdler (1958). Zarafonetis et al (1957) describe the unique sequence of pernicious anaemia, polycythaemia, and acute leukaemia occurring in the same patient.…”

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confidence: 99%

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Megaloblastic Anaemia Alternating with Polycythaemia Vera

Chalmers¹,

Richards²

1961

BMJ

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

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Megaloblastic Anaemia Alternating with Polycythaemia Vera

Chalmers¹,

Richards²

1961

BMJ

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“…The probability that coexistent pernicious anemia and polycythemia vera are two separate diseases has been suggested by several observers. Leukocytosis was noted in 5 cases (17–19, 21, 23) at the time of the diagnosis of pernicious anemia. Ellman and Bowdler (17) observed that the leukocytosis probably indicated latent polycythemia, the full clinical picture emerging after the remission of pernicious anemia.…”

Section: Discussionmentioning

confidence: 99%

Development of Polycythemia Vera After Treatment for Pernicious Anemia: Report of a Case

Kenny

Berman

1963

J American Geriatrics Society

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The interrelation of various disorders of the white blood cells has been well established. The transformation from one histologic picture of malignant lymphoma to another, and the coexistence of different histologic pictures in the lymph nodes of one subject, also have been well documented. Further, the intriguing problem of the evolution of the various myeloproliierative syndromes has been a frequent subject of discussion. However, reports on the coexistence of a myeloproliferative disorder and pernicious anemia in the same patient are rare.Recently we observed a patient with pernicious anemia who, four months after the institution of treatment with vitamin Blz parenterally, presented with the clinical picture of polycythemia Vera. The purpose of this paper is to report the case, review the pertinent literature, and discuss the possible interrelationship of the two diseases. CASE REPORT First hospital admissionA 75-year-old white male was first admitted t o the hospital on September 12, 1961, complaining of weakness , progressive dyspnea, anorexia , weight loss, epigastric distress and dizziness. Pertinent physical findings a t that time were recorded aa generalized pallor and periorbital edema.The past medical history revealed seasonal allergy (hay fever) since 1916, requiring some desensitization and antihistamine therapy. He also had had several episodes of allergic asthma requiring symptomatic therapy, but the last severe attack had occurred in 1948. Other than minor illnesses, the patient had had no other significant difficulty until August 1958, when he saw his family physician because of vertigo. His blood pressure was 130/90 mm. Hg, pulse 80, temperature 98.6" F., and weight 170% pounds. H i s hemoglobin level a t that time was 10 gm. per 100 ml. An electrocardiogram showed frequent premature beats. He was treated by his physician with one dose (100 micrograms) of B,z and was given ironvitamin capsules which he took for three consecutive weeks. He received no further medical attention until the present admission. Family history and social history were noncont ri but ory . X-ray ezamination:A chest roentgenogram showed no pulmonary parenchymal disease. The left ventricle of the heart was moderately enlarged. Roentgenograms of the gastrointestinal tract did not show any organic disease.Laboratory findings: The hemoglobin level was 4.5 gm. per 100 ml., hematocrit 15%, erythrocyte count 1,520,000 per cu. mm., and leukocyte count 2,700 per cu. mm., with 27% neutrophils, 6% myelocytes, 2% eosinophils, 3% basophils, 3% juvenile cells, and 56% lymphocytes. The erythrocytes exhibited anisocytosis and poikilocytosis, and the majority were macrocytic. The polymorphonuclear leukocytes showed hypersegmentation of the

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Pernicious Anemia and Polycythemia Vera in One Patient

Engel¹

1962

Arch Intern Med

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Pernicious Anaemia and Polycythaemia Vera

Abstract: The aetiology of polycythaemia vera remains obscure despite much speculation since the disease was first described by Vacquez in I892. It was characterized as a ' malignant hyperplasia' by Minot and Buckman (1923)

Cited by 8 publications

References 8 publications

Megaloblastic Anaemia Alternating with Polycythaemia Vera

Megaloblastic Anaemia Alternating with Polycythaemia Vera

Development of Polycythemia Vera After Treatment for Pernicious Anemia: Report of a Case

Pernicious Anemia and Polycythemia Vera in One Patient

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