Introduction: Biermer’s disease is an autoimmune cause of anemia characterized by malabsorption of vitamin B12. It is often accompanied by other autoimmune pathologies. The objective was to study its profile in patients followed in the internal medicine department of the Abass Ndao hospital center. Methods: This was a retrospective and descriptive study of patients followed for Biermer’s disease from January 1, 2014 to December 31, 2019 (5 years). Results: 57 cases were collected, an incidence of 5.4 in the internal medicine department. The sex ratio was 0.58, an average age of 56.4 years. The circumstances of discovery were dominated by anemic syndrome (87.7%), dermatological (33.3%), digestive (29.8%), neurological (20%) pathologies. The specific signs to Biermer’s disease were digestive manifestations in 70.2% (including 30% Hunter’s glossitis), neurological manifestations in 36.8% (including 17.5% paresthesias), palmoplantar melanoderma in 68.4%. The mean hemoglobin level was 6.8 g/dL with a mean corpuscular volume of 110.7 fl. The myelogram reported megaloblastosis in 100% of the cases. The mean serum vitamin B12 level was 100 pg/ml. The anti-intrinsic factor antibody assay performed in 50 patients was positive in all cases. Upper digestive endoscopy showed an aspect of fundic atrophy in 69%. Histology showed intestinal metaplasia in 2 patients. An autoimmune disease was associated in 21% of cases. All patients had received treatment with vitamin B12 (51 patients took intramuscularly and 6 oral treatment). The course was favorable in all cases with a complete correction of the anemia. Conclusion: Biermer’s disease is a reality in Senegal. Its clinical and biological characteristics can be superimposed on the data in the literature. His prognosis under treatment is good whatever the route of administration of vitamin B12.
References
[1]
Zulfiqar, A.A., Serraj, K., Pennaforte, J.L. and Andrès, E. (2012) Maladie de Biermer: De la physiopathologie À la clinique. Médecine thérapeutique, 18, 21-29.
[2]
Baker, S.J. (1979) Hyperpigmentation and Pernicious Anemia in Blacks. Archives of Internal Medicine, 139, 1316-1316. https://doi.org/10.1001/archinte.1979.03630480088028
[3]
Federici, L., Henoun, L.N., Zimmer, J., Affenberger, S., Maloisel, F. and Andrès, E. (2007) Manifestations hématologiques de la carence en vitamine B12: Données personnelles et revue de la littérature. La Revue de Médecine Interne, 28, 225-223. https://doi.org/10.1016/j.revmed.2006.10.319
[4]
Serraj, E.K., Mecili, M., Ciobanu, E., Vogel, T. and Weitten, T. (2009) Mise au point sur la vitamine B12 Andres administrée par voie orale. Annales d’Endocrinologie, 70, 455-461. https://doi.org/10.1016/j.ando.2009.07.001
[5]
Koulidiati, J., Sawadogo, S., Sagna, Y., Somda, K.S., Tieno, H., Kafando, E., et al. (2015) Pernicious Anemia: Diagnosis and Course in Burkina Faso. Medecine et Sante Tropicales, 25, 428-431. https://doi.org/10.1684/mst.2014.0417
[6]
Ndiaye, F.S.D., Fall, S., Sarr, A., Laraki, S.D., Ka, M.M. and Diop, T.M. (2009) Données actuelles sur la maladie de Biermer. Hématologie, 15, 473-477. https://doi.org/10.1684/hma.2009.0394
[7]
Amrani, R., Esseddiki, A., Messaoudi, S. and Tazi, N. (2014) La maladie de biermer: Une entité rare en pédiatrie. Revue marocaine de santé publique, 1, 35-37.
[8]
Wun Chan, J.C., Yu Liu, H.S., Sang Kho, B.C., Yin Sim, J.P., Hang Lau, T.K., Luk, Y.W., et al. (2006) Pernicious Anemia in Chinese: A Study of 181 Patients in a Hong Kong Hospital. Medicine (Baltimore), 85, 129-138. https://doi.org/10.1097/01.md.0000224710.47263.70
[9]
Savage, D., Gangaidzo, I., Lindenbaum, J., Kiire, C., Mukiibi, J.M., Moyo, A., et al. (1994) Vitamin B12 Deficiency Is the Primary Cause of Megaloblastic Anaemia in Zimbabwe. British Journal of Haematology, 86, 844-850. https://doi.org/10.1111/j.1365-2141.1994.tb04840.x
[10]
Agarwal, M.B. and Manocha, S. (2000) Acquired Hyperhomocysteinemia, Megaloblastosis with Subacute Combined Degeneration and Deep Venous Thrombosis. The Journal of the Association of Physicians of India, 48, 545-546.
[11]
Diop, M.M. (2014) Maladie de biermer de cours inhabituel: A propos d’associations avec une beta-thalassemie et un syndrome de Plummer Vinson. Revue du CAMES: Science de la santé, 2, 45-48.
[12]
Segbena, A.Y., Ambofo-Planche, Y., Gbadoe, A.D., Dogba, A.D., Kueviakoe, I.M., Vovor, A. and David, M. (2003) A propos de quatre observations de maladie de Biermer en Afrique de l’ouest. Medecinetropicale, 63, 593.
[13]
Maktouf, C., Bchir, F., Louzir, H., Elloumi, M., Abid, H.B., Mdhaffer, M., et al. (2007) Le spectre clinique des déficits en cobalamines en Tunisie. Annales de biologie clinique (Paris), 1, 135-142.
[14]
Btissame, E.-S. (2017) Anémie de Biermer: Polymorphisme clinique, caractéristiques épidémiologiques, thérapeutiques et évolutives, étude d’une série de 50 cas colligés au service de médecine interne de l’hôpital militaire de Moulay IsmaïlMeknes.
[15]
Andrès, E., Affenberger, S., Vinzio, S., Noel, E., Kaltenbach, G. and Schlienger, J.-L. (2005) Carences en vitamine B12 chez l’adulte: Etiologies, manifestations cliniques et traitement. La Revue de Médecine Interne, 26, 938-946. https://doi.org/10.1016/j.revmed.2005.04.036
[16]
Loukili, N.H., Noel, E., Blaison, G., Goichot, B.,et al. (2004) Données actuelles sur la maladie de Biermer. À propos d’une étude rétrospective de 49 observations. La Revue de Médecine Interne, 25, 556-561. https://doi.org/10.1016/j.revmed.2004.03.008
[17]
Annibale, B. (2005) Lack of Specific Association between Gastric Autoimmunity Hallmarks and Clinical Presentations of Atrophic Body Gastritis. World Journal of Gastroenterology, 11, 5351. https://doi.org/10.3748/wjg.v11.i34.5351
[18]
Rufenacht, P., Iten, A. and Mach-Pascual, S. (2008) Hypovitaminose B12: Challenge diagnostique et thérapeutique. Revue Médicale Suisse, 4, 2212-2217.
[19]
Eussen, S.J.P.M. (2005) Oral Cyanocobalamin Supplementation in Older People with Vitamin B12 Deficiency: A Dose-Finding Trial. Archives of Internal Medicine, 23, 1167. https://doi.org/10.1001/archinte.165.10.1167
[20]
Kaltenbach, G., Andrès, E., Barnier-Figue, G., et al. (2005) Low Vitamin B12 Levels in Elderly Patients Cured within One Week by Oral Cobalamin Therapy. Presse Medicale, 34, 358-362.
[21]
Drissi, J., Kassidi, F., Kouach, J., et al. (2015) Combined Degeneration of the Spinal Cord Diagnosed during Pregnancy: Report of a Case. International Journal of Innovation and Applied Studies, 12, 899.
[22]
Loukili, N.H. and Andrès, E. (2003) Vitamine B12 chez l’adulte: Du métabolisme aux carences. Cœur, 15, 30.
[23]
Andrès, E., Renaux, V., Campos, F., et al. (2001) Troubles neurologiques isolés révélant une maladie de Biermer chez le sujet jeune. La Revue de Medecine Interne, 22, 389-393. https://doi.org/10.1016/S0248-8663(01)00352-6
[24]
Ach, M.T., Akkari, I., Maaroufi, A., Kacem, M., Chaieb, M. and Ach, K. (2016) Anémie de Biermer et maladies auto-immunes: A propos de 28 cas. Annales d’Endocrinologie, 77, 375. https://doi.org/10.1016/j.ando.2016.07.402