Unique sequence of pernicious anemia, stomach cancer, and myelodysplastic syndrome

Kondo, Haruki; Imamura, Takaaki

doi:10.1002/(sici)1096-8652(199912)62:4<261::aid-ajh15>3.0.co;2-4

Am. J. Hematol.

1999

DOI: 10.1002/(sici)1096-8652(199912)62:4<261::aid-ajh15>3.0.co;2-4

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Unique sequence of pernicious anemia, stomach cancer, and myelodysplastic syndrome

Haruki Kondo

Takaaki Imamura

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Concurrent pernicious anemia and myelodysplastic syndrome

Davis

Byrd

2001

Ann Hematol

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Megaloblastic anemia (MA) due to vitamin B12 deficiency is a reversible form of ineffective hematopoiesis. Myelodysplastic syndrome (MDS) is an acquired, irreversible disorder of ineffective hematopoiesis, characterized by stem cell dysfunction as a consequence of DNA damage manifested in part by karyotype anomalies. Importantly, MA and MDS are generally considered mutually exclusive diagnoses. We report the case of a 73-year-old woman with a profound macrocytic anemia, monocytosis and neurologic symptoms. Low cobalamin levels and the presence of anti-intrinsic-factor antibodies definitively established a diagnosis of pernicious anemia. Replacement therapy resulted in resolution of neurologic findings and macrocytosis; however, the anemia and monocytosis persisted. Bone marrow biopsy revealed trilineage myelodysplasia, which together with the peripheral monocytosis suggested a diagnosis of chronic myelomonocytic leukemia. Karyotype analysis revealed a clone with 45, XX, +der(1;7)(q10;p10)-7 [20]. Eighteen months after documented vitamin B12 replenishment her MDS transformed to terminal acute myeloid leukemia with the same clonal abnormality. Reversible cytogenetic abnormalities have been observed with MA, occasionally including karyotypes typically associated with MDS or myeloid leukemias. These abnormalities, like the anemia, resolve with vitamin replacement. This case suggests that MA and MDS can occur simultaneously; clinicians should be aware that this phenomenon occurs. Whether acquired karyotype abnormalities from the MA were related to the MDS and subsequent myeloid leukemia in this woman is a speculative but intriguing consideration that is discussed.

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Concurrent pernicious anemia and myelodysplastic syndrome

Davis

Byrd

2001

Ann Hematol

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Myelodysplastic Syndrome and Polymyalgia Rheumatica Associated With Pernicious Anemia

Otsuka¹,

Higuchi²,

Nakajima³

et al. 2015

J Hematol

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An 83-year-old man who had been treated for pernicious anemia (PA) developed myelodysplastic syndrome (MDS) and polymyalgia rheumatica (PMR). While PA patients are at an increased risk of malignant tumors, association with MDS is rarely reported. PA patients are also associated with various autoimmune conditions; however, association with PMR has not been reported. Derangement in the immune system associated with PA and subsequent MDS was assumed to have contributed to the development of PMR.

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Unique sequence of pernicious anemia, stomach cancer, and myelodysplastic syndrome

Cited by 2 publications

References 5 publications

Concurrent pernicious anemia and myelodysplastic syndrome

Concurrent pernicious anemia and myelodysplastic syndrome

Myelodysplastic Syndrome and Polymyalgia Rheumatica Associated With Pernicious Anemia

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