Pernicious anemia associated with autoimmune hemolytic anemia and alopecia areata.
ABSTRACT We report a 16-year-old male with a combination of pernicious anemia, auto-immune hemolytic anemia and alopecia areata. Autoimmune hemolytic anemia coexisted with pernicious anemia but was diagnosed only when the anemia failed to respond to cobalamin therapy. Alopecia areata occurred 9 years later.
Article: Alopecia areata and auto-immunity.[show abstract] [hide abstract]
ABSTRACT: The prevalence of auto-antibodies against thyroid constituents, gastric parietal cells, smooth muscle cells, mitochondria, reticulin, nuclear constituents and rheumatoid factor in 108 patients with alopecia areata was compared with that found in a previous survey of the local population. Female patients had a significantly increased prevalence of anti-thyroid antibodies which were present in 30% overall and in 44% of the youngest age group (11-17 years). Smooth muscle antibodies were more frequent in female patients but the increase was not significant. Male patients had a significant increased prevalence of thyroid and gastric parietal cell antibodies (11.4% each). In females, antithyroid antibodies were associated with extensive hair loss: they were found in 42% of female patients with total alopecia and only 20% of males with total hair loss. A family history of alopecia areata was obtained from 24% of patients; 10% had relatives with thyroid disease and 10% had diabetic relatives. These findings confirm the association between alopecia areata and the other auto-immune diseases.British Journal of Dermatology 09/1981; 105(2):153-7. · 3.76 Impact Factor
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ABSTRACT: The frequency of alopecia areata and observed patterns of heritability are in keeping with a polygenic inheritance model but the genetics of alopecia areata is still poorly understood. The role of environmental factors in triggering disease initiation or exacerbation remains almost entirely speculative. Using the candidate gene approach, three susceptibility/severity factors have been identified. HLA alleles were the first to show a strong association with alopecia areata and some DQB and DR alleles have been demonstrated to confer a high risk for disease by both case-control and family-based studies. Interleukin (IL)-1 cluster genes, mainly the IL-1 receptor antagonist, show a strong association with disease severity in alopecia areata and a number of other autoimmune and inflammatory diseases. Finally, the association of alopecia areata with Down's syndrome, the high frequency of alopecia areata in autoimmune polyglandular syndrome type I due to mutations of the autoimmune regulator (AIRE) gene on chromosome 21q22.3 and the finding of association with MX1, another gene in the Down's syndrome region of chromosome 21 indicate this area of the genome as a promising target for future-family based investigations. The role of individual genes of the MHC, IL-1 cluster or chromosome 21q22.3 is difficult to establish and further genetic and functional investigations are needed to confirm their involvement in the pathogenesis of alopecia areata.Clinical and Experimental Dermatology 08/2002; 27(5):405-9. · 1.33 Impact Factor
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ABSTRACT: Pernicious anemia appears to be autoimmune in origin and is associated with immune disorders of several organ systems. We report 4 patients with pernicious anemia and immune cytopenias, an association that may sometimes pose diagnostic problems unless specifically considered. Pernicious anemia coexisted with or was closely followed by idiopathic thrombocytopenic purpura in 3 patients and by autoimmune hemolytic anemia in a 4th patient. In addition to cobalamin therapy, all patients required corticosteroids (2 also received danazol), while 1 also required splenectomy. All 4 patients were women. The 3 patients with idiopathic thrombocytopenic purpura were also blood group O and were iron-deficient. Autoimmune cytopenias may occur in patients with treated or untreated pernicious anemia and require specific therapy.European Journal Of Haematology 02/1990; 44(1):18-23. · 2.55 Impact Factor