Prevalence of undiagnosed pernicious anemia in the elderly
Prevalence of undiagnosed pernicious anemia in the elderly
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DOI：
10.1001/archinte.156.10.1097
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发表时间：
1996-05-27
影响因子：
--
通讯作者：
Carmel, R
中科院分区：
文献类型：
--
作者：
Carmel, R
背景资料：关于恶性贫血患病率的现有信息主要基于较早的调查，这些调查倾向于对先前诊断的疾病进行回顾性分析，并且通常研究同质的欧洲人群。缺乏目前的数据在美国，除其他事项外，阻碍了讨论的建议，以增加叶酸的摄入量由一般population.Objective：估计未确诊和未经治疗的恶性贫血的患病率among the elderly.Methods：一项前瞻性调查钴胺素水平和抗内因子抗体在老年人。血液检测在729人年龄在60岁或以上，并提供与席林试验和其他测试的后续评估时，结果异常。结果：17个主题被发现有恶性贫血，通常只有最低限度的钴胺素缺乏症的临床表现。虽然三名受试者的医生怀疑钴胺素缺乏，但他们没有得到充分的治疗，仍然有缺乏的证据。从分析中排除这三名部分治疗的受试者，1.9%的调查人群患有未被识别和未经治疗的恶性贫血。患病率为2.7%的女性和1.4%的男性，4.3%的黑人妇女和4.0%的白色妇女有恶性anemia.Conclusions：未确诊的恶性贫血是一种常见的发现，在老年人，尤其是黑人和白色妇女。如果这些发现可以外推，美国近80万老年人患有未诊断和未治疗的恶性贫血，因此，如果暴露于大量叶酸，可能会有隐性钴胺素缺乏症的风险。这一数字不包括那些因其他疾病而缺乏钴胺素的老年人，也不包括那些患有未被认识到的恶性贫血和其他缺乏原因的人数尚不清楚的年轻人。
Background: Existing information about the prevalence of pernicious anemia is largely based on older surveys that favored florid manifestations, tended to be retrospective analyses of previously diagnosed disease, and usually studied homogeneous European populations. The lack of current data in the United States has, among other things, hampered discussions of the proposal to increase folate intake by the general population.Objective: To estimate the prevalence of undiagnosed and untreated pernicious anemia among the elderly.Methods: A prospective survey of cobalamin levels and anti-intrinsic factor antibody was done in the elderly. Blood testing was done in 729 people aged 60 years or older and follow-up assessment with the Schilling test and other tests was offered when results were abnormal.Results: Seventeen subjects were found to have pernicious anemia, usually with only minimal clinical manifestations of cobalamin deficiency. Although cobalamin deficiency had been suspected by the physicians of three subjects, they had been treated inadequately and still had evidence of deficiency. Excluding these three partially treated subjects from the analysis, 1.9% of the survey population had unrecognized and untreated pernicious anemia. The prevalence was 2.7% in women and 1.4% in men; 4.3% of the black women and 4.0% of the white women had pernicious anemia.Conclusions: Undiagnosed pernicious anemia is a common finding in the elderly, especially among black and white women. If these findings can be extrapolated, almost 800 000 elderly people in the United States have undiagnosed and untreated pernicious anemia, and, thus, would be at possible risk for masked cobalamin deficiency if exposed to large amounts of folate. This number does not include those elderly with cobalamin deficiency caused by other disorders or the still unknown number of younger people with unrecognized pernicious anemia and other causes of deficiency.