Cutting Edge Issues in Autoimmune Gastritis

Toh, Ban‐Hock; Chan, James; Kyaw, Tin; Alderuccio, Frank

doi:10.1007/s12016-010-8218-y

Cited by 87 publications

(41 citation statements)

References 61 publications

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“…Of these, H1K1-ATPase, the most common autoantigen in PA, is a possible target of an autoimmune mechanism triggered by H pylori by means of antigenic mimicry. [51][52][53][54][55] Conversely, H pylori eradication in patients with autoimmune atrophic gastritis is followed by improved gastric acid and ascorbate secretion in many, and partial or complete remission of atrophic gastritis in a variable proportion of patients. [56][57][58][59][60] In our experience, H pylori eradication is followed by a significant decrease in serum gastrin levels in almost all patients, but complete remission accompanied by disappearance of circulating antiparietal cell antibodies (APCAs) is only observed in a limited number of patients.…”

Section: Relation Between Autoimmune Gastritis and H Pylori Infectionmentioning

confidence: 99%

How I treat unexplained refractory iron deficiency anemia

Hershko

Camaschella

2014

Blood

133

140

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Endoscopic gastrointestinal workup fails to establish the cause of iron deficiency anemia (IDA) in a substantial proportion of patients. In patients referred for hematologic evaluation with unexplained or refractory IDA, screening for celiac disease, autoimmune gastritis, Helicobacter pylori, and hereditary forms of IDA is recommended. About 4% to 6% of patients with obscure refractory IDA have celiac disease, and autoimmune gastritis is encountered in 20% to 27% of patients. Stratification by age cohorts in autoimmune gastritis implies a disease presenting as IDA many years before the establishment of clinical cobalamin deficiency. Over 50% of patients with unexplained refractory IDA have active H pylori infection and, after excluding all other causes of IDA, 64% to 75% of such patients are permanently cured by H pylori eradication. In young patients with a history suggestive of hereditary iron deficiency with serum ferritin higher than expected for IDA, mutations involving iron trafficking and regulation should be considered. Recognition of the respective roles of H pylori, autoimmune gastritis, celiac disease, and genetic defects in the pathogenesis of iron deficiency should have a strong impact on the current diagnostic workup and management of unexplained, or refractory, IDA.

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Section: Relation Between Autoimmune Gastritis and H Pylori Infectionmentioning

confidence: 99%

How I treat unexplained refractory iron deficiency anemia

Hershko

Camaschella

2014

Blood

133

140

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“…Without history of gastrectomy, then anti-intrinsic factor antibodies or anti-parietal cell antibodies will be indicative of PA [5]. However, some experts recommend endoscopy to confirm gastritis and rule out gastric cancers, which have been noted to be increased in PA [12].…”

Section: Discussionmentioning

confidence: 99%

“…The samples obtained endoscopically confirmed chronic atrophic gastritis affecting the gastric body and antrum. Methylmalonic acid levels in urine were requested; the results were 271 mg/g/creat [4][5][6][7][8][9][10][11][12][13][14][15]. With the information gathered so far from the clinical aspects and the focused investigations, a diagnosis of megaloblastic anemia due to pernicious anemia was made and therapy instituted with daily hydroxocobalamin injections (1000 µg) for 1 week, weekly injections for one month, and monthly injections thereafter.…”

Section: Journal Of Hematology and Thromboembolic Diseasesmentioning

confidence: 99%

Challenges in Diagnosing Pernicious Anemia: A Case Series

Mwenda¹

2014

J Hematol Thrombo Dis

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“…The other major parietal cell autoantigen has been identified as H Although these autoantibodies are associated with the development of autoimmune gastritis, and are predictive of the cobalamin malabsorption that leads to the development of pernicious anemia [128], it remains generally accepted that experimental autoimmune gastritis is primarily a T-cell mediated disease [129,130]. Nonetheless, taken together, these two autoantibody populations could explain the symptoms and progression of disease in autoimmune gastritis.…”

Section: Autoantibodies To H + /K + Atpase and Gastric Intrinsic Factormentioning

confidence: 99%

The Role of Pathogenic Autoantibodies in Autoimmunity

Rowley

Whittingham

2015

Antibodies

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Abstract:The serological presence of autoantibodies is diagnostic of autoimmunity, and these autoantibodies may be present for many years before the presentation of autoimmune disease (AID). Although a pathogenic role has been demonstrated for various autoantibodies reactive with cell surface and extracellular autoantigens, studies using monoclonal antibodies (mAb) show not all antibodies in the polyclonal response are pathogenic. Differences depend on Fab-mediated diversity in epitope specificity, Fc-mediated effects based on immunoglobulin (Ig) class and subclass, activation of complement, and the milieu in which the reaction occurs. These autoantibodies often occur in organ-specific AID and this review illustrates their pathogenic and highly specific effects. The role of autoantibodies associated with intracellular antigens is less clear. In vitro they may inhibit or adversely affect well-defined intracellular biochemical pathways, yet, in vivo they are separated from their autoantigens by multiple cellular barriers. Recent evidence that Ig can traverse cell membranes, interact with intracellular proteins, and induce apoptosis has provided new evidence for a pathogenic role for such autoantibodies. An understanding of how autoantibodies behave in the polyclonal response and their role in pathogenesis of AID may help identify populations of culprit B-cells and selection of treatments that suppress or eliminate them.

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Cutting Edge Issues in Autoimmune Gastritis

Cited by 87 publications

References 61 publications

How I treat unexplained refractory iron deficiency anemia

How I treat unexplained refractory iron deficiency anemia

Challenges in Diagnosing Pernicious Anemia: A Case Series

The Role of Pathogenic Autoantibodies in Autoimmunity

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