Autoimmune Phenomena in Pernicious Anaemia

Abstract

PARACERvICAL NERVE BLOCK MEDICAL JOURNAL was obvious that very substantial relief of pain was obtained in most cases. Each patient was also carefully questioned, but, in order that the results could be judged with the least possible bias, no comment was made to the patient at the time of the injection, save to explain that an examination was to be made. Ten minutes after the injection the result was assessed by asking the patient, " How are the pains ? " without giving any suggestion of 'expected relief. When recorded and analysed the answers indicated " complete" or " very good " relief of pain in 71%, "partial relief " in 25%, and "no relief " in 4%.These results may be compared with those of other workers, which for this purpose are expressed under similar headings, and on a percentage basis to the nearest unit.

Gastric Acidity and Gastric Biopsy in Thyrotoxicosis

“…Irvine, Davies, Delamore, and Williams (1962) noted complement-fixing antibodies to thyroid in 37 % of cases of pernicious anaemia compared with 4% of hospital control patients, and similarly they found that approximately 25% of patients with spontaneous hypothyroidism or Hashimoto's thyroiditis had positive complement-fixation tests with gastric mucosa as compared with 4% of the hospital controls. Doniach, Roitt, and Taylor (1963) likewise found that the incidence of thyroid antibodies was significantly higher in perniciousanaemia patients without overt thyroid disease than in normal controls and that there was an increased incidence of gastric cytoplasmic antibodies in thyrotoxicosis and Hashimoto's disease.…”

Thyroglobulin and microsomal antibodies in patients with insulin dependent diabetes mellitus and their relatives.

“…An increased incidence of thyroid and gastric autoantibodies in relatives of patients with Hashimoto's thyroiditis was also demonstrated by Doniach (1965). A similar trend was found in relatives of patients with SLE (Leonhardt et al, 1964).…”

“…In several autoimmune diseases such as systemic lupus erythematosus (Leonhardt et al 1964), Hashimoto's thyroiditis (Doniach al. 1965), Graves' disease (Evans et al 1967), family studies have revealed increased incidence of thyroid antibodies in relatives.…”

Parietal-cell antibodies in patients undergoing gastric surgery.

“…Similarly there is an increased incidence of gastric carcinoma in patients with pernicious anaemia (Jenner, 1939). Antibodies to gastric parietal cells are detectable by immunofluorescence in the serum of 80-90% of patients with pernicious anaemia (Taylor et al, 1962 ;Doniach et al, 1963;Coghill et al, 1965) and of some with simple chronic atrophic gastritis (Coghill et al, 1965). It has been suggested that the gastric changes in pernicious anaemia are in some way related to an immune response, but there is no direct evidence that humoral antibodies are pathogenetic in the gastritis of pernicious anaemia, though they may reflect an underlying disturbance of cellular immunity.…”