International Journal of Hematology

, Volume 84, Issue 3, pp 238–241 | Cite as

Coexistence of Megaloblastic Anemia and Iron Deficiency Anemia in a Young Woman with Chronic Lymphocytic Thyroiditis

  • Shih-Hsiang Chen
  • Chia-Sui Hung
  • Chao-Ping Yang
  • Fu-Sung Lo
  • Hsun-Hui Hsu
Case report


Pernicious anemia is a megaloblastic anemia caused by vitamin B12 deficiency, and is the end-stage of autoimmune gastritis that typically affects persons older than 60 years. It is the most common cause of vitamin B12 deficiency. Pernicious anemia can also be diagnosed concurrently with other autoimmune diseases. We report the occurrence of megaloblastic anemia in a 22-year-old woman with chronic autoimmune thyroiditis for 10.5 years. Recently, she presented with microcytic anemia, and iron deficiency anemia was diagnosed initially. After administration of ferrous sulfate, macrocytic anemia was revealed and vitamin B12 deficiency was detected. Pernicious anemia was highly suspected because of the endoscopic finding of atrophic gastritis, and high titer of antigastric parietal cell antibody, as well as elevated serum gastrin level. After intramuscular injections of hydroxycobalamine 100 μg daily for 10 days, and monthly later, her blood counts returned to normal.

Key words

Pernicious anemia Vitamin B12 deficiency Iron deficiency anemia Chronic lymphocytic thyroiditis 


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Copyright information

© The Japanese Society of Hematology 2006

Authors and Affiliations

  • Shih-Hsiang Chen
    • 1
  • Chia-Sui Hung
    • 2
  • Chao-Ping Yang
    • 1
  • Fu-Sung Lo
    • 2
  • Hsun-Hui Hsu
    • 2
  1. 1.Division of Pediatric Hematology/OncologyChang Gung Memorial Hospital, Chang Gung University College of Medicine, Chang Gung Children’s HospitalTaoyuanTaiwan
  2. 2.Divisions of Pediatric EndocrinologyChang Gung Memorial Hospital, Chang Gung University College of Medicine, Chang Gung Children’s HospitalTaoyuanTaiwan

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