A 24 yr old female presenting with fatigue and breathlessness and rash around neck. She has a history of raised IgE levels. CBC was done giving pictures of megaloblastic anaemia. CRP is raised. What can be possible diagnosis?? Reports are attached.

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SUGGESTIVE. OF PERNICIOUS ANEMIA NEEDS B 12 FOLIC. ACID..

Treat pernicious anemia, give vitamin B12

Thanks Dr. Pushker Bhomia, Dr.Dinesh Gupta
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She had low vitamin B 12 and low hemoglobin with raised mean corpuscular volume which is suggestive of megaloblastic Anemia She also had raised IgE level 1) Raised IgE level points to autoimmune causes of vitamin B 12 deficiency. Pernicious Anemia is commonest cause of autoimmune disease causing vitamin B 12 deficiency. In this disease there are antibodies developed to intrinsic factor. Which causes deficiency of intrinsic factor. For absorption of vitamin B 12, it must combine with intrinsic factor for it to get absorbed. Lack of intrinsic factor causes vitamin B 12 deficiency. Diagnostic test involves Anti intrinsic factor antibody Anti parietal cell antibody testing Upper GI endoscopy to look for atrophic gastritis Treatment involves injectable vitamin B 12 administration or nasal drop preparation of vitamin B 12 2) Other causes of vitamin B 12 deficiency include Dietary deficiency - most vegetarian diet lack vitamin B 12 Crohn's disease Coeliac disease Distal ileal pathology such as tuberculosis, surgical resection

Patient is vegetrarian
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Anemia Rx Inj fejet iv with ns 100ml Orofer xt od Folvite 5mg bd Multivitamin syrup Antihistamin tab od

Pernicious Anemia Rx include - To correct the deficiency of Vitamin B12 in the form of injectables or pills. Injection Methylcobalmin 500-1500 mcg every alternate day-weekly. Tablet Methylcobalmin 1 mg OD.

24 YEARS OLD FEMALE HAS FATIGUE BRESTHLESSNESS RASH AROUND NECK ANEAMIA ON CBC CRP IS RAISED IGE RAISED COULD BE A KIND OF VASCULITIS COULD BE POSSIBLE' CONNECTIVE TISSUE DISORDER

Sir i have sent the levels for lft kft ana and panca
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Scabies

Pernicious anemia. Haematinics. Inj ,Neurobion, Antiallergics, antihistamines.

Megloblastic Anemia Further evaluation is required for diagnosis and treatment Consult Haematologist

Possibly pernicious anemia. Adv parietal cell antibodies. Injectable B12 replacement.

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