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24 Table 3 Estimated Sensitivity and Specificity of Serum Laboratory Tests for Vitamin B12 Deficiency Pernicious anemia refers to one of the hematologic manifestations of chronic auto-immune gastritis, in which the immune system targets the parietal cells of the stomach or intrinsic factor itself, leading to decreased absorption of vitamin B 12

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doi: 10.1373/49.8.1367 37

[5] When B12 and folate deficiency coexist, B12 replacement should be started before or alongside folic acid (typically 5mg daily) to avoid worsening neurological symptoms