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Addison-Biermer disease

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Historic term for pernicious anaemia or megaloblastic anaemia, secondary to vitamin B12 deficiency. It is characterized by faulty maturation of the erythrocytes with the formation of abnormally large megaloblastic precursors. It occurs most commonly in middle-aged individuals and is associated with weakness, pallor, shortness of breath, digital paresthesia, numbness, lack of coordination, spasticity, difficulty in walking, decreased sense of taste and smell, mental dullness, and sometimes psychoses. Gastrointestinal changes include achylia gastrica, diarrhea, and constipation. Both sexes affected.

Descriptions based on single cases were done by Sir Thomas Addison and Hermann Lebert in 1849, the classic description by Michael Anton Biermer in 1868-1872. James Scarth Combe (1796-1883) had reported a case of pernicious anaemia as early as 1822. Paul Ehrlich (1854-1915) was the first to distinguish the aplastic type of anaemia.

It was the French internist Armand Trousseau (1801-1867) who suggested that the disease should bear Addison's name.


  • J. S. Combe:
    History of a case of anaemia.
    Transactions of the Medico-Chirurgical Society of Edinburgh, 1824, 1: 194-204.
    First description of pernicious anaemia. Paper read May 1, 1822.
  • T. Addison:
    Anaemia-Disease of the supra-renal capsules.
    London Hospital Gazette, 1849, 43: 517-518.
  • T. Addison:
    On the Constitutional and Local Effects of Disease of the Suprarenal Capsules.
    London, S. Higley, 1855.
    Reprinted in Medical Classics, 1937, 2: 244-277.
    Facsimile edition, London, Dawson, 1968.
  • H. Lebert:
    Die Krankheiten der Blut- und Lymphgefässe.
    In: Rudolf Virchow, publisher: Handbuch der speciellen Pathologie und Therapie, volume 5, part 2: 1-152. 1st edition, Erlangen 1861 (6 volumes, Erlangen, 1854-1876).
  • M. A. Biermer:
    Eine eigenthümliche Form von progressiver perniciöser Anämie.
    Correspondenz-Blatt für Schweizer Aerzte, Basel, 1872, 2: 15-18.
    Preliminary communication in:
    Versammlung deutscher Naturforscher und Aerzte, 1868, Tageblatt No. 8, IX Sect., page 173.
    Vereins-Berichte. Gesellschaft der Aerzte des Kantons Zürich. 123. Sitzung der ärztlichen Gesellschaft des Kantons Zürich. [Bericht über späteren Morbus Biermer].
  • P. Ehrlich:
    Über einen Fall von Anämie mit Bemerkungen über regenerative Veränderungen des Knochenmarks.
    Charité-Annalen, Berlin, 1888, 13: 300-309.
We thank Rudolf Kleinert, Bad Reichenhall, Germany, for information submitted.

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