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Living with Imerslund-Grasbeck syndrome

A condition with low vitamin B12 that leads to a blood problem called megaloblastic anemia.

Understanding Imerslund-Grasbeck syndrome

Imerslund-Grasbeck syndrome is a condition caused by low levels of vitamin B12 (cobalamin).

Its main feature is megaloblastic anemia, a shortage of red blood cells in which the cells are unusually large. About half of people also have protein in the urine, though kidney function appears normal. It typically begins in infancy or early childhood.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Megaloblastic anemia
  • Poor growth and weight gain (failure to thrive)
  • Pale skin
  • Excessive tiredness
  • Repeated stomach or breathing infections
  • Protein in the urine

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include blood and bone marrow specialists, digestive system specialists, genetic specialists and kidney specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

Care & treatment

Care team
Blood and bone marrow specialists (hematologists); Digestive system specialists (gastroenterologists); Genetic specialists (geneticists); Kidney specialists (nephrologists)
Expert care
Ask about multidisciplinary care centers for rare conditions
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with National Kidney Foundation and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Which genes are involved, and can we test for them?
How do you monitor my B12 level and blood counts?
Should we keep watching the protein in my urine?

Quick facts

Symptoms usually startChild
InheritanceAutosomal Recessive

Changes in genes cause this condition. It is inherited in an autosomal recessive pattern, meaning a child inherits a changed copy of the gene from each parent.

GeneticKidneyGastrointestinalBloodInherited Metabolic

Also known as: enterocyte cobalamin malabsorption; enterocyte intrinsic factor receptor, defect of; familial megaloblastic anaemia; familial megaloblastic anemia; imerslund disease; imerslund-grasbeck anemia

Patient organizations

Source: NIH GARD · Imerslund-Grasbeck syndromeGARD ID 7006 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Imerslund-Grasbeck syndrome.

Explore the Imerslund-Grasbeck syndrome blog

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