PATHOPHYSIOLOGY OF PERNICIOUS ANEMIA

ETIOLOGY PRECIPITATING FACTORS PREDISPOSING FACTORS

H. Pylori Ischemia bile Salts Lifestyle – alcoholism

NSAIS’s acids Age
Aspirin

Bacteria penetrates the gastric cells

Weakens mucous layer

Breakdown of gastric mucosal barrier

Acid – back diffusion into mucosa

↑ acid and pepsin release ↑ vasodilation

Normotension Destruction of mucosal cell Histamine

Inadequate Further Destruction Bleeding

mucosal ↑ acid and pepsin
of blood release
mucosal blood Loss of Mucosal
flow erotion vessels plasma edema
CHON in
Tissue anoxia Gastric
Destruction
Decreased gastric lumen
& acidosis mucosal
of parietal
HCl of
Tissue
↓ secretion ↓ Absorption Release Vit B12 Pernicious
Tissue injury atrophy
Secretion
cells
hypoxia
IF of Vit. B12ULCERATION
Nerve
Release
PAIN
irritation
PGE
histamine deficiency
2
anemia