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Symptoms of pernicious anemia are variable from case to case, but are relegated mainly to hematological and neurological manifestations.
Hematology of vitamin B12 deficiency
Anemia is the main serious manifestation of vitamin B12 deficiency, since DNA manufacturing is impaired by the loss of vitamin B12 function. Symptoms of anemia include shortness of breath, fatigue, and chest pain. The peripheral blood smear shows hypersegmented neutrophils. Macrocytosis is a well-known finding of vitamin B12 deficiency.
Neurological syndrome of vitamin B12 deficiency
Chronic vitamin B12 deficiency, over time, can lead to a neurological syndrome including loss of appetite, diarrhea, tingling and numbness of hands and/or feet. Neuropathy, the tingling and numbness that affects those with pernicious anemia, is a later manifestation of the disease, and may not be reversible with treatment. Patients are often labeled as malingerers, or the neuropathy may be ascribed to other causes, such as diabetes or a primary neurological problem. Those individuals who experience fatigue often also have problems with concentration loss and extreme irritability.
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