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Malabsorption in Pernicious Anemia

Ann Intern Med. 1968;69(5):1070-1071. doi:10.7326/0003-4819-69-5-1070
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Lack of secretion of gastric intrinsic factor with resultant inadequate absorption of vitamin B12 is the hallmark of pernicious anemia. Destruction of the gastric mucosa by an autoimmune reaction is currently receiving most attention as the cause of the gastric atrophy, although the precise mechanism is still uncertain. Whatever the mechanism, progressive atrophy of the gastric mucosa occurs with virtual loss of all gastric secretions (achylia gastrica) in addition to loss of intrinsic factor. Thus, intestinal absorption might be affected deleteriously in pernicious anemia by at least two factors:

1. Digestive inadequacy owing to loss of gastric hydrochloric acid and


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