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W. W. DUKE, M.D.; D. D. STOFER, M.D.
Arch Intern Med (Chic). 1922;30(1):94-98. doi:10.1001/archinte.1922.00110070097007.
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Patients afflicted with pernicious anemia present many symptoms which differ strikingly from those of secondary anemia. One is the discrepancy between the general appearance of a patient with pernicious anemia and his blood count. Patients with secondary anemia having a red blood cell count of 2,000,000 or less, are not only weak and ill enough to be in bed, but have a pallor so marked as to be noticeable even to the most casual observer. In contrast with this, patients who have pernicious anemia may be up and around and may have color in the face and lips which is so good that one is often surprised at the finding of an extremely low red blood cell count, from 1,000,000 to 1,500,000. In fact, often their color is so good that the anemia is overlooked by their physicians. The pallor may be partly obscured by the lemon yellow tinge of


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