{"id":"https://openalex.org/W4409440367","doi":"https://doi.org/10.12659/ajcr.946911","title":"A Rare Case of Severe Pernicious Anemia with Neuropsychiatric Implications","display_name":"A Rare Case of Severe Pernicious Anemia with Neuropsychiatric Implications","publication_year":2025,"publication_date":"2025-04-12","ids":{"openalex":"https://openalex.org/W4409440367","doi":"https://doi.org/10.12659/ajcr.946911","pmid":"https://pubmed.ncbi.nlm.nih.gov/40413579"},"language":"en","primary_location":{"id":"doi:10.12659/ajcr.946911","doi":"https://doi.org/10.12659/ajcr.946911","is_oa":true,"landing_page_url":"https://doi.org/10.12659/ajcr.946911","pdf_url":"https://amjcaserep.com/download/inPress/idArt/946911","source":{"id":"https://openalex.org/S2756455307","display_name":"American Journal of Case Reports","issn_l":"1941-5923","issn":["1941-5923"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline"],"host_organization":"https://openalex.org/P4310320062","host_organization_name":"International Scientific Information Inc.","host_organization_lineage":["https://openalex.org/P4310320062"],"host_organization_lineage_names":["International Scientific Information Inc."],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Case Reports","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://amjcaserep.com/download/inPress/idArt/946911","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5037469433","display_name":"Stanley E. Kim","orcid":"https://orcid.org/0000-0001-9522-3693","observed_orcids":["https://orcid.org/0000-0001-9522-3693"]},"institutions":[{"id":"https://openalex.org/I2800638548","display_name":"Kern Medical Center","ror":"https://ror.org/01eyb5f38","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2800638548"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Stanley Kim","raw_affiliation_strings":["Division of Hematology-Oncology, Department of Medicine, Kern Medical, Bakersfield, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Hematology-Oncology, Department of Medicine, Kern Medical, Bakersfield, USA","institution_ids":["https://openalex.org/I2800638548"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Jade Punzalan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I893474871","display_name":"American University of the Caribbean School of Medicine","ror":"https://ror.org/02hnxxp83","country_code":"SX","type":"education","lineage":["https://openalex.org/I893474871"]}],"countries":["SX"],"is_corresponding":false,"raw_author_name":"Jade Punzalan","raw_affiliation_strings":["Medical student, American University of The Caribbean School of Medicine, Miramar, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medical student, American University of The Caribbean School of Medicine, Miramar, USA","institution_ids":["https://openalex.org/I893474871"]}]},{"author_position":"last","author":{"id":null,"display_name":"BreeAnna Carlson","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I93393672","display_name":"Western University of Health Sciences","ror":"https://ror.org/05167c961","country_code":"US","type":"education","lineage":["https://openalex.org/I93393672"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"BreeAnna Carlson","raw_affiliation_strings":["Medical student, Western University of Health Science College of Osteopathic Medicine of The Pacific-Northwest Arizona, Glendale, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Medical student, Western University of Health Science College of Osteopathic Medicine of The Pacific-Northwest Arizona, Glendale, USA","institution_ids":["https://openalex.org/I93393672"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0915058,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"26","issue":null,"first_page":"e946911","last_page":"e946911"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10499","display_name":"Folate and B Vitamins Research","score":0.9937000274658203,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10499","display_name":"Folate and B Vitamins Research","score":0.9937000274658203,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13374","display_name":"Hematological disorders and diagnostics","score":0.003599999938160181,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12441","display_name":"Porphyrin Metabolism and Disorders","score":0.0007999999797903001,"subfield":{"id":"https://openalex.org/subfields/1312","display_name":"Molecular Biology"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/pernicious-anemia","display_name":"pernicious anemia","score":0.9980000257492065},{"id":"https://openalex.org/keywords/vitamin-b12-deficiency","display_name":"vitamin B12 deficiency","score":0.9700000286102295},{"id":"https://openalex.org/keywords/intrinsic-factor-antibodies","display_name":"intrinsic factor antibodies","score":0.7549999952316284},{"id":"https://openalex.org/keywords/methylmalonic-acid","display_name":"methylmalonic acid","score":0.8029999732971191},{"id":"https://openalex.org/keywords/hypersegmented-neutrophils","display_name":"hypersegmented neutrophils","score":0.9660000205039978},{"id":"https://openalex.org/keywords/megaloblastic-anemia","display_name":"megaloblastic anemia","score":0.8579999804496765},{"id":"https://openalex.org/keywords/schizophrenia","display_name":"schizophrenia","score":0.7620000243186951},{"id":"https://openalex.org/keywords/homocysteine","display_name":"homocysteine","score":0.8059999942779541},{"id":"https://openalex.org/keywords/neuropsychiatric-symptoms","display_name":"neuropsychiatric symptoms","score":0.6060000061988831},{"id":"https://openalex.org/keywords/severe-anemia","display_name":"severe anemia","score":0.5379999876022339}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9723794460296631},{"id":"https://openalex.org/C2775916456","wikidata":"https://www.wikidata.org/wiki/Q1346016","display_name":"pernicious anemia","level":3,"score":0.8996695280075073},{"id":"https://openalex.org/C2778248108","wikidata":"https://www.wikidata.org/wiki/Q5445","display_name":"Anemia","level":2,"score":0.5394307971000671},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.4160422682762146},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.4002884328365326},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.31652069091796875}],"mesh":[{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000175","qualifier_name":"diagnosis","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000523","qualifier_name":"psychology","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D000752","descriptor_name":"Anemia, Pernicious","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008764","descriptor_name":"Methylmalonic Acid","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D008764","descriptor_name":"Methylmalonic Acid","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D008764","descriptor_name":"Methylmalonic Acid","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012559","descriptor_name":"Schizophrenia","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D012559","descriptor_name":"Schizophrenia","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D012559","descriptor_name":"Schizophrenia","qualifier_ui":"Q000150","qualifier_name":"complications","is_major_topic":true},{"descriptor_ui":"D014805","descriptor_name":"Vitamin B 12","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D014805","descriptor_name":"Vitamin B 12","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D014805","descriptor_name":"Vitamin B 12","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D014806","descriptor_name":"Vitamin B 12 Deficiency","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014806","descriptor_name":"Vitamin B 12 Deficiency","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014806","descriptor_name":"Vitamin B 12 Deficiency","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.12659/ajcr.946911","doi":"https://doi.org/10.12659/ajcr.946911","is_oa":true,"landing_page_url":"https://doi.org/10.12659/ajcr.946911","pdf_url":"https://amjcaserep.com/download/inPress/idArt/946911","source":{"id":"https://openalex.org/S2756455307","display_name":"American Journal of Case Reports","issn_l":"1941-5923","issn":["1941-5923"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline"],"host_organization":"https://openalex.org/P4310320062","host_organization_name":"International Scientific Information Inc.","host_organization_lineage":["https://openalex.org/P4310320062"],"host_organization_lineage_names":["International Scientific Information Inc."],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Case Reports","raw_type":"journal-article"},{"id":"pmid:40413579","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40413579","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American journal of case reports","raw_type":"Journal Article"},{"id":"pmh:oai:pubmedcentral.nih.gov:12121450","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/12121450","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Am J Case Rep","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.12659/ajcr.946911","doi":"https://doi.org/10.12659/ajcr.946911","is_oa":true,"landing_page_url":"https://doi.org/10.12659/ajcr.946911","pdf_url":"https://amjcaserep.com/download/inPress/idArt/946911","source":{"id":"https://openalex.org/S2756455307","display_name":"American Journal of Case Reports","issn_l":"1941-5923","issn":["1941-5923"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","medline"],"host_organization":"https://openalex.org/P4310320062","host_organization_name":"International Scientific Information Inc.","host_organization_lineage":["https://openalex.org/P4310320062"],"host_organization_lineage_names":["International Scientific Information Inc."],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"American Journal of Case Reports","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"sustainable_development_goals_aurora":[],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4409440367.pdf","grobid_xml":"https://content.openalex.org/works/W4409440367.grobid-xml"},"referenced_works_count":1,"referenced_works":["https://openalex.org/W112947606"],"related_works":["https://openalex.org/W1995907924","https://openalex.org/W4390507849","https://openalex.org/W2075248083","https://openalex.org/W2971257165","https://openalex.org/W2087926837","https://openalex.org/W2297314391","https://openalex.org/W857079722","https://openalex.org/W2415671045","https://openalex.org/W1557953801","https://openalex.org/W2116334597"],"abstract_inverted_index":{"BACKGROUND":[0],"Pernicious":[1],"anemia":[2,135,157,209,229],"(PA)":[3],"is":[4,14,223],"caused":[5],"by":[6,138,194,218],"a":[7,67,70,102,139],"deficiency":[8,25],"in":[9,22,237],"intrinsic":[10],"factor":[11],"(IF),":[12],"which":[13,191],"necessary":[15],"for":[16],"vitamin":[17,23,141,241],"B12":[18,24,142,242],"(cobalamin)":[19],"absorption,":[20],"resulting":[21],"and":[26,88,114,123,150,152,210],"subsequent":[27],"megaloblastic":[28],"anemia.":[29,232],"Diagnosis":[30],"of":[31,37,56,66,72,79,104,112,133,146,166,174,227,246],"PA":[32],"relies":[33],"on":[34],"the":[35,57,64],"detection":[36],"circulating":[38],"antibodies":[39],"to":[40,44,182],"IF.":[41],"In":[42],"addition":[43],"anemia,":[45,81,84],"patients":[46],"can":[47],"develop":[48],"neuropsychiatric":[49],"conditions,":[50],"such":[51],"as":[52],"subacute":[53],"combined":[54],"degeneration":[55],"spinal":[58],"cord":[59],"or":[60],"psychosis.":[61],"We":[62],"present":[63],"case":[65,226],"patient":[68],"with":[69,101,108,230,240],"history":[71,103],"schizophrenia":[73,105,211,247],"who":[74],"exhibited":[75],"unusually":[76],"severe":[77,109,183],"manifestations":[78],"pernicious":[80,134,228],"including":[82],"life-threatening":[83,231],"multiple":[85],"hypersegmented":[86,202,215,234],"neutrophils,":[87],"significantly":[89],"elevated":[90],"methylmalonic":[91,147],"acid":[92,148],"(MMA)":[93,149],"levels.":[94],"CASE":[95],"REPORT":[96],"A":[97,131,196],"51-year-old":[98],"Hispanic":[99],"woman":[100],"was":[106,120,128,136,177],"admitted":[107],"weakness,":[110],"shortness":[111],"breath,":[113],"diarrhea.":[115],"The":[116,214,233,244],"hemoglobin":[117],"(Hb)":[118],"level":[119],"2.5":[121],"g/dL":[122],"mean":[124],"corpuscular":[125],"volume":[126],"(MCV)":[127],"133":[129],"fL.":[130],"diagnosis":[132],"made":[137],"low":[140],"level,":[143],"high":[144],"levels":[145],"homocysteine,":[151],"positive":[153],"IF-blocking":[154],"antibodies.":[155],"Her":[156],"did":[158],"not":[159],"improve":[160],"initially,":[161],"even":[162],"after":[163],"3":[164],"units":[165],"blood":[167,198],"were":[168,192],"transfused.":[169],"She":[170],"had":[171],"no":[172],"signs":[173],"bleeding.":[175],"It":[176],"thought":[178],"that":[179],"hemoconcentration":[180],"due":[181],"dehydration":[184],"falsely":[185],"raised":[186],"her":[187,208],"initial":[188],"Hb":[189],"levels,":[190],"corrected":[193],"hydration.":[195],"peripheral":[197],"smear":[199],"showed":[200],"many":[201],"neutrophils.":[203],"With":[204],"parenteral":[205],"cyanocobalamin":[206],"therapy,":[207],"symptoms":[212,245],"improved.":[213,249],"neutrophils":[216,235],"disappeared":[217,236],"2":[219,238],"weeks.":[220],"CONCLUSIONS":[221],"This":[222],"an":[224],"extreme":[225],"weeks":[239],"therapy.":[243],"also":[248]},"counts_by_year":[],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2025-10-10T00:00:00"}
