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<p>It is important that patients suffering from pernicious anaemia, the result of
a vitamin B12 (cobalamin) deficiency, receive a prompt and appropriate diagnosis.
Pernicious anaemia develops gradually, and can cause a range of symptoms, including
fatigue, lethargy, feeling faint and headaches, which vary from patient to patient.
Because of the gradual progression of the condition, the variety of symptoms, which
are shared with a range of other conditions, diagnosis at early onset can be challenging.</p><p>To
support the diagnosis of pernicious anaemia, the British Committee for Standards in
Haematology (BCSH) has published <em>Guidelines for the diagnosis and treatment of
Cobalamin and Folate disorders,</em> which sets out that cobalamin status is the recommended
first line diagnostic test. However, the guidance states that there is no gold standard
test for the condition and makes it clear that the clinical picture of a patient is
the most important factor in assessing the significance of the test results. This
means clinicians should take into account all of the symptoms the patent is experiencing,
their medical history, age and other relevant factors when considering the implications
of a patient’s cobalamin status. The BCSH guidance highlights the risk of neurological
impairment if treatment is delayed.</p><p><br /> The BCSH operates independently of
Department and NHS England and produces evidence based guidelines for both clinical
and laboratory haematologists on the diagnosis and treatment of haematological disease,
drawing on the advice of expert consultants and clinical scientists practicing in
the United Kingdom. It would be for the BCSH, not the Department, to consider whether
any adjustments to current best practice in the diagnosis and treatment of patients
with pernicious anaemia were needed, including whether any new or additional tests
were appropriate. A copy of the BCSH guidance document <del class="ministerial">has
already been placed in the Library and</del> is attached.</p><p><br /> More general
clinical guidance on the diagnosis and management of pernicious anaemia can also be
found on the National Institute for Health and Care Excellence (NICE) Clinical Knowledge
Summaries website. This is a freely accessible online resource that covers the causes,
symptoms, diagnosis and treatment of pernicious anaemia, as well as potential complications
of the condition. In addition to this, NHS Choices provides similar, though less technical,
information on pernicious anaemia for the public.</p>
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