It is well known that patients with pernicious anemia have a more or less pronounced tendency toward edema, and that they usually have edema, especially in the later stages of the disease. Edema has always been considered a link in the clinical symptomatology of this disease, but a closer study of its pathogenesis has been limited. In most instances, edema is understood to be nephrogenetic (Makarow1), but it is also thought to be determined by extrarenal factors (Saltzman2). In both cases, the authors seem inclined to regard the anemia itself, the low hemoglobin percentage, as the determining factor.
Again, in patients with pernicious anemia, one finds a characteristic change in the excretion of water. Christian3 and Stieglitz4 stated that patients generally show a tendency toward fixation of the specific gravity of the urine without accompanying polyuria and with a relative increase of the nocturnal urine. Saltzman,
MEULENGRACHT E, IVERSEN P, NAKAZAWA F. PERNICIOUS ANEMIA: EDEMA AND REDUCTION IN EXCRETION OF WATER. Arch Intern Med (Chic). 1928;42(3):425–439. doi:https://doi.org/10.1001/archinte.1928.00020020113014
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