ACASM - Overview: Pernicious Anemia Cascade

Test Catalog

Test Name

Test ID: ACASM    
Pernicious Anemia Cascade

Useful For Suggests clinical disorders or settings where the test may be helpful

Diagnosis of pernicious anemia


Diagnosis of vitamin B12 deficiency-associated neuropathy

Reflex Tests Lists tests that may or may not be performed, at an additional charge, depending on the result and interpretation of the initial tests

Test IDReporting NameAvailable SeparatelyAlways Performed
IFBPAIntrinsic Factor Blocking Ab, SYes, (order IFBA)No
MMAPAMethylmalonic Acid, QN, SYes, (order MMAS)No
GASTRGastrin, SYes, (order GAST)No

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

If vitamin B12 is <150 ng/L, then intrinsic factor blocking antibody (IFBA) is performed. If IFBA is negative or indeterminate, then gastrin is performed.

If vitamin B12 is 150 to 400 ng/L, then methylmalonic acid (MMA) is performed. If MMA is >0.40 nmol/mL, then IFBA is performed.


See Vitamin B12 Deficiency Evaluation in Special Instructions.

Special Instructions and Forms Library of PDFs including pertinent information and consent forms, specimen collection and preparation information, test algorithms, and other information pertinent to test

Method Name A short description of the method used to perform the test

Immunoenzymatic Assay

NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.


Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name

Pernicious Anemia Cascade

Aliases Lists additional common names for a test, as an aid in searching

B12 Assay
B12 Deficiency
Cobalamin Deficiency
Intrinsic Factor Blocking Antibody
Islet Cell Tumor
Methylmalonic Acid (MMA)
MMA (Methylmalonic Acid)
Schilling Testing (Alternative Strategy)
Type 1 Intrinsic Factor Antibody
Vitamin B 12