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This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur

In these cases, the dark color may be an indication of advanced kidney problems

doi: 10.7860/JCDR/2017/26031.9799

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H1-antihistamines: inverse agonism, anti-inflammatory actions and cardiac effects