A 67-year-old woman complains of paresthesia's in the limbs. Examination shows loss of vibratory sense, positional sense, and sense of light touch in the lower limbs. She is found to have pernicious anemia. Endoscopy reveals an ulcer in the body of the stomach. What does she most likely have?
High-Yield Explanation
Patients with pernicious anemia have achlorhydria and an increased risk (about 5%) of developing gastric carcinoma. There is a deficiency in vitamin B12 that leads to megaloblastic anemia and neurologic involvement (subacute degeneration of the dorsal and lateral spinal columns).