Pernicious anemia is an advanced form of vitamin B-12 deficiency characterized by weakness, sore tongue, paresthesias (tingling and numbness) of extremities, and gastrointestinal symptoms such as diarrhea, nausea, vomiting, and pain. Pernicious anemia is believed to be an autoimmune disorder in which the parietal cells of the stomach lining fail to secrete enough intrinsic factor to ensure intestinal absorption of vitamin B-12 (the extrinsic factor). This is due to atrophy of the glandular mucosa of the fundus of the stomach and is associated with absence of hydrochloric acid (achlorhydria).
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