Diagnosis and Management of Pernicious Anemia

Pernicious anemia is a macrocytic anemia due to cobalamin deficiency, which is the result of intrinsic factor deficiency. Pernicious anemia is associated with atrophic body gastritis, whose diagnostic criteria are based on the histologic evidence of gastric body atrophy associated with hypochlorhydria. Serological markers suggesting the presence of oxyntic mucosa damage are increased levels of fasting gastrin and decreased levels of Pepsinogen I. Without the now obsolete Schilling’s test, intrinsic factor deficiency may not be proven, and gastric intrinsic factor output after pentagastric stimulation has been proposed. Intrinsic factor autoantibodies are useful surrogate markers of pernicious anemia. The management of patients with pernicious anemia should focus on the life-long replacement treatment with cobalamin and the monitoring to early diagnose an eventual onset of iron deficiency. Moreover, these patients should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.     

Hoffa’s fat pad impingement treated arthroscopically: related findings on preoperative MRI in a case series of 62 patients

Introduction  

The morphology of painful impingement of the infrapatellar fat pad (Hoffa’s disease), which is characterized by inflammation, swelling, hypertrophy, fibrosis, and/or calcifications, has been well described. The purpose of this study was to investigate whether corresponding characteristic MRI findings could be assessed in patients with infrapatellar fat pad impingement.