Profile of Biermer’s Disease at the Medical Clinic II Abass Ndao Hospital Center: About 57 Colliged Cases

Abstract

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.