Jaundice also occurs in pernicious anemia, with soreness and reddening of the tongue, difficulty in swallowing, and digestive disturbances, including diarrhea. Other symptoms may include fatigability, heart palpitation, and dyspnea. Changes in the nerves and spinal cord may produce numbness and tingling in the fingers and toes, and the gait may become unsteady. The involvement of the nerves can be completely cured if it has existed for less than 6 months, but may be incurable if it is of long standing. In advanced cases, mental disturbances may also occur.
Laboratory tests reveal abnormalities in the erythrocytes in the blood and in the bone marrow.
Gastric analysis shows an absence of hydrochloric acid and perhaps even an absence of gastric juice. This treatment must be lifelong to prevent relapse. The injections do not cure the disease but arrest it by providing the body directly with the necessary vitamin that it fails to absorb from the digestive tract. Special diets, liver extract, and other medications taken by mouth usually are not required since the basic defect is not dietary deficiency but improper use of food ingested. The etiology of pernicious anemia is unknown although there appears to be an autoimmune component, as anti-intrinsic factor antibodies are often found.