Absence of hydrochloric acid in the stomach contents is regarded as an essential point in the diagnosis of pernicious anemia.1 Absence of hydrochloric acid is a noteworthy feature in other conditions producing similar anemia, as cancer of the stomach and sprue.
The possibility of achlorhydria as a causal factor in pernicious anemia has been considered.2 In support of this are cited cases of gastrectomy followed by pernicious anemia; e. g., Hartman's case,3 and Moynihan's4 case and five cases mentioned by Hurst.5 In further support of a causal relationship between achlorhydria and pernicious anemia, or as a matter of medical interest, cases have been reported in which the achlorhydria preceded the anemia by years. Hurst has reported one case of twelve years, Faber6 one of ten years.
The following case is of over fourteen years' duration, from the time of known achlorhydria to the onset
STURTEVANT M. ACHLORHYDRIA PRECEDING PERNICIOUS ANEMIA: REPORT OF A CASE OF MORE THAN FOURTEEN YEARS' DURATION. JAMA. 1925;85(21):1638–1639. doi:10.1001/jama.1925.02670210040013
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