Pernicious anemia is a blood disorder caused by a lack of vitamin B12. Patients who have this disorder do not produce a protein (intrinsic factor) in the stomach that allows the body to absorb vitamin B12.

Pernicious anemia is characterized by the presence in the blood of large, immature, nucleated cells (megaloblasts) that are forerunners of red blood cells. (Red blood cells, when mature, have no nucleus). Pernicious anemia is therefore one of the types of megaloblastic anemia.

Doctors diagnose pernicious anemia when a patient with a low red blood cell count has large red blood cells and white blood cells with large, multi-lobed nuclei. The patient often has antibodies in the blood called intrinsic factor and parietal cell antibodies. A test that measures that lack of absorption of B12 (Schillings test) can be used to support the diagnosis.

Nowadays, pernicious anemia is not so pernicious. Pernicious anemia is simply treated with vitamin B12. The vitamin B12 has to be administered by injection because people with pernicious anemia do not have adequate protein intrinsic factor (or an effective form of intrinsic factor) and so cannot absorb vitamin B12 taken by mouth.

There is some evidence that pernicious anemia may be genetic although its mode of inheritance is poorly documented. There is a congenital form of pernicious anemia due to defect of intrinsic factor at birth that is clearly inherited as an autosomal recessive trait with the affected child having received two copies of the gene, one from each parent. The intrinsic factor gene itself has been localized to human chromosome 11.

Pernicious anemia was first described in 1855 by the English physician Thomas Addison. The name "pernicious anemia" was coined in 1872 by the German physician Anton Biermer. The studies of George H. Whipple on the effects of feeding liver in anemia followed by those of George R. Minot and Wm. P. Murphy on the effects of feeding liver specifically in pernicious anemia led to the cure of pernicious anemia and to their receiving the Nobel Prize in 1934.

The word "pernicious" means highly injurious, destructive, or deadly. "Pernicious" comes from the Latin root "nex" meaning "violent death." Pernicious anemia was once quite deadly. Today it fortunately is not.

Pernicious anemia has also been called Addison anemia, addisonian anemia, Biermer anemia.

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