Pernicious Anemia With a Normal Serum Vitamin B12 Level in a Case of Chronic Granulocytic Leukemia

Arch Intern Med. 1966;117(1):32-33. doi:10.1001/archinte.1966.03870070046005.
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THE PRESENT REPORT describes a case of addisonian pernicious anemia which was first recognized in a patient who was already known to be suffering from chronic granulocytic leukemia. The main point of interest is the level of vitamin B12 in the serum, which was normal as estimated by microbiological assay despite the presence of other hematological evidence of vitamin B12 deficiency.

Report of a Case 

Initial Diagnosis.  —In October 1963 a housewife, 60 years of age, complained of breathlessness on exertion, abdominal discomfort, and occasional vomiting from which she had suffered for two months. She was hospitalized four years previously with symptoms related to chronic rheumatic heart disease. Slight macrocytosis of the red blood cells had been noted in the peripheral blood film at this time although she was not anemic (hemoglobin level, 14.1 gm/100 ml). A histamine fast achlorhydria had been demonstrated, but no further investigations had


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