Your doctor will diagnose pernicious anemia based on your medical and family histories, a physical exam, and the results from tests.
Your doctor will want to find out whether the condition is due to a lack of intrinsic factor or another cause. He or she also will want to find out how severe the problem is, so it can be treated properly.
Primary care doctors, such as family doctors, internists, and pediatricians (doctors who treat children), often diagnose and treat pernicious anemia. Other kinds of doctors also may be involved, including:
Medical and Family Histories
Your doctor may ask about your signs and symptoms. He or she also may ask:
During the physical exam, your doctor may check for pale or yellowish skin and an enlarged liver. He or she may listen to your heart for a rapid heartbeat or heart murmur.
Your doctor also may check for signs of nerve damage. He or she may want to see how well your muscles, eyes, senses, and reflexes work. Your doctor may ask questions or do tests to check your mental status, coordination, and ability to walk.
Diagnostic Tests and Procedures
Blood tests and procedures can help diagnose pernicious anemia and find out what's causing it.
Complete Blood Count
Often, the first test used to diagnose many types of anemia is a complete blood count (CBC). This test measures many different parts of your blood. For this test, a small amount of blood is drawn from a vein (usually in your arm) using a needle.
A CBC checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.
The normal range of these levels may be lower in certain racial and ethnic populations. Your doctor can explain your test results to you.
The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of anemia, a blood disorder, an infection, or another condition.
Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells. MCV can be a clue as to what's causing your anemia. In pernicious anemia, the red blood cells are larger than normal (macrocystic).
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