Anti-parietal cell antibodies – diagnostic significance

Rusak, Ewa; Chobot, Agata; Krzywicka, Agnieszka; Wenzlau, Janet M.

doi:10.1016/j.advms.2015.12.004

Cited by 87 publications

(85 citation statements)

References 44 publications

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“…Weak support is proposed because atrophic gastritis detection is dependent on biopsy number and location and thus can be missed, and parietal cell antibodies (70–80%) and intrinsic factor antibodies (20–40%) are not positive in all patients with atrophic gastritis, thus atrophic gastritis can be missed with this approach [124, 125, 166–169]. …”

Section: Discussion and Proposal Of New Criteria To Support Thementioning

confidence: 99%

Diagnosis of Zollinger–Ellison Syndrome in the Era of Ppis, Faulty Gastrin Assays, Sensitive Imaging and Limited Access to Acid Secretory Testing

Metz

Cadiot

Poitras

et al. 2017

Int. J. Endo. Oncol.

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In recent years the diagnosis of Zollinger-Ellison syndrome (ZES) has become increasingly controversial with several new approaches and criteria proposed, differing from the classical biochemical criterion of inappropriate hypergastrinemia (i.e., hypergastrinemia in the presence of hyperchlorhydria) (Table 1). These changes have come about because of the difficulty and potential dangers of stopping proton pump inhibitors (PPIs) for gastric acid analysis; the recognition than many of the current assays used to assess gastrin concentrations are unreliable; the development of sensitive imaging modalities that detect neuroendocrine tumors (NETs) including an increasing number of the primary gastrinomas; the increased use of percutaneous or endoscopic ultrasound (EUS)-directed biopsies/cytology and the general lack of availability of acid secretory testing. In this article we will discuss the basis for these controversies, review the proposed changes in diagnostic approaches and make recommendations for supporting the diagnosis of ZES in the modern era.

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Section: Discussion and Proposal Of New Criteria To Support Thementioning

confidence: 99%

Diagnosis of Zollinger–Ellison Syndrome in the Era of Ppis, Faulty Gastrin Assays, Sensitive Imaging and Limited Access to Acid Secretory Testing

Metz

Cadiot

Poitras

et al. 2017

Int. J. Endo. Oncol.

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“…Iron deficiency anemia, which is often present in patients with AIG, should be identified by levels of hemoglobin, mean corpuscular volume (MCV), serum iron, ferritin, total iron-binding capacity (TIBS) and serum transferrin receptor (TfR). In patients with suspected carcinoid tumor transformation the measurement of chromogranin A, which is secreted by the ECL cells, can be useful, although it shows low specificity (23%) and false-positive results in patients with inflammatory bowel disease, renal insufficiency and other conditions [4, 23, [35][36][37][38][39][40][41][42][43][44][45].…”

Section: Diagnostic Approach 41 Serological Testsmentioning

confidence: 99%

Current View on Autoimmune Gastritis

Kovacheva-Slavova¹,

Angelov²,

Valkov³

et al. 2019

Gastritis - New Approaches and Treatments

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Autoimmune gastritis (AIG) is a chronic inflammatory disease of the gastric corpus and fundus. Although still unclear, genetic and environmental factors, antigenic mimicry or cross-reactivity are proposed pathogenic mechanisms. Parietal cells destruction results in loss of intrinsic factor and increased gastric pH due to hypochlorhydria and G-cell proliferation. Furthermore, atrophy, intestinal, pancreatic and spasmolytic polypeptide-expressing metaplasia are observed. AIG is underdiagnosed, however, proper diagnostic approach, including endoscopic, serological and histopathological assessment, is required. Gastroscopy with corpus and fundus biopsies is a gold standard. A serological combination of anti-parietal cell antibodies, intrinsic factor antibody, anti-Helicobacter pylori IgG, gastrin, pepsinogen I and pepsinogen I/II ratio improves the diagnostic sensitivity and specificity and allows atrophy level prediction. AIG might manifest with multifactorial iron deficiency anemia, vitamin B12 deficiency (pernicious anemia), neurological and neuropsychiatric conditions, small intestinal bacterial overgrowth and gastrointestinal infections. AIG association with other autoimmune diseases is wellestablished. Gastric cancer and gastric carcinoid are neoplastic transformations of a continuous chronic inflammation. Patients with AIG should be carefully monitored as no specific AIG therapy is available and disease complication could be fatal.

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“…The H + /K + -ATPase proton pump is a membrane-bound enzyme located in the parietal cells of the stomach that is responsible for exchanging hydrogen ions into the gastric lumen to produce hydrochloric acid. Anti-Parietal Cell Antibodies (APCA) are directed against the alpha and possibly the beta subunits of H + /K + -ATPase proton pump [28,29]. APCA are also detected in 20% of patients infected with Helicobacter pylori although no pathogenic link has been clearly demonstrated [29].…”

Section: Introductionmentioning

confidence: 99%

“…Anti-Parietal Cell Antibodies (APCA) are directed against the alpha and possibly the beta subunits of H + /K + -ATPase proton pump [28,29]. APCA are also detected in 20% of patients infected with Helicobacter pylori although no pathogenic link has been clearly demonstrated [29]. Interestingly, the H+/K+-ATPase proton pump is expressed by the human airway epithelium, particularly in the seromucinous glands [30,31], but its expression in the IPF lung was never evaluated specifically.…”

Section: Introductionmentioning

confidence: 99%