Pernicious anemia symptoms

# A patient with pernicious anemia often consults the dentist for relief of:
A. Edematous buccal mucosa
B. Severe gingivitis
C. Glossitis
D. Denuded gingiva

The correct answer is: C. Glossitis

Pernicious anemia is a relatively common, chronic, progressive, megaloblastic anemia. It is caused by the lack of secretion of the intrinsic factor in normal gastric juice. This factor is necessary for adequate absorption of vitamin B12, which is necessary for the maturation of erythrocytes. As a result, they produce fewer erythrocytes than normal.

The onset of pernicious anemia usually is insidious and vague. As the condition progresses, there will be a sore, painful tongue (atrophic glossitis), angular cheilitis, a tingling numbness of the extremities, difficulty swallowing (dysphagia), painful swallowing (odynophagia). 

A Schilling 24-hour urine test is done to evaluate whether vitamin B 12 is being absorbed by the body and is most commonly used to evaluate patients for pernicious anemia.