A 71-year-old woman presents with progressive fatigue, paresthesias, and gait imbalance over 3 months. Vital signs: BP 128/76, HR 88, RR 16, temp 37°C, SpO2 98%. Examination reveals decreased vibration and proprioception in both legs; normal strength. Labs show hemoglobin 8.7 g/dL, MCV 113 fL, hypersegmented neutrophils, elevated methylmalonic acid, and normal folate levels. She denies medication use. Which diagnosis best explains these findings?
- A)Iron deficiency anemia
- B)Folate deficiency
- C)Pernicious anemia causing vitamin B12 deficiencyGABARITO
- D)Thalassemia trait
- E)Sideroblastic anemia
Explicação
Pernicious anemia causing vitamin B12 deficiency is correct. Macrocytosis with hypersegmented neutrophils and neurologic deficits involving the dorsal columns strongly point to vitamin B12 deficiency. Pernicious anemia results from autoimmune destruction of pa... Ver explicação completa e trilha adaptativa →