Links Between Helicobacter pylori Infection, Cobalamin Deficiency, and Pernicious Anemia

Stopeck, Alison

doi:10.1001/archinte.160.9.1229

Cited by 41 publications

(33 citation statements)

References 18 publications

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“…Gastric bypass surgery, gluten enteropathy, some drugs and Helicobacter pylori gastritis are common causes of vitamin B12 malabsorption 1,5,16,[21][22][23][24][25][26][27][28][29] Although only 85 patients underwent endoscopic evaluation in our study, Helicobacter pylori positive gastritis rate was found quite frequently (77.6%), which is concordant with the findings of a previously published paper. 25 In that article, authors noted that Helicobacter pylori IgG values were not statistically different between the patients with low and normal vitamin B12 levels, although they were slightly higher in low B12 group.…”

Section: Discussionsupporting

confidence: 91%

“…The most common reason accounting for deficiency is inadequate intake. [1][2][3][4][5]9,11,12,15,[20][21][22][23][24][25][26][27][28][29] Our study also displays the importance of inadequate intake of Vit B12-rich food items in the occurence of serum Vit B12 deficiency. As well known, dietary deficiency is most commonly observed among strict vegetarians, alcoholics and elderly.…”

Section: Discussionmentioning

confidence: 75%

See 1 more Smart Citation

The Properties of Vitamin B12 Deficiency in the Patients of an Outpatient Clinic

Erden¹,

Şakar²,

Koç³

et al. 2010

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob b j je ec c t ti i v ve e: : The aim of this study is to eva lu a te the pro per ti es of vi ta min B12 de fi ci ency and pre dis po sing fac tors in the pa ti ents of an out pa ti ent cli nic. M Ma a t te e r ri i a al l a an nd d M Me et t h ho od ds s: : Four hundred pa ti ents with vi ta min B12 de fi ci ency we re stu di ed. Ant hro po met ric me a su res, bi oc he mi cal analy sis, gas tric pa ri e tal cell an ti bo di es and pa ra si tes in sto ol of the pa ti ents, an tig li a din an ti body sur vey and up per gas tro in tes ti nal system en dos copy we re per for med. Ad di ti o nally, ran domly se lected 100 pa ti ents with low and 100 he althy sub jects with nor mal se rum vi ta min B12 le vels we re ques ti o ned abo ut fo od in ta ke. R Re e s su ul lt ts s: : Ove rall ra ti o of vi ta min B12 de fi ci ency among out pa ti ents was 4%. Co e xis ting di se a ses such as di a be tes mel li tus (12.3%), hyper ten si on (42.0%), hyper li pi de mi a (42.0%) and obe sity (42.0%) we re de ter mi ned. Ne arly a qu ar ter (22,8%) had au to im mu ne thyro id di se a se. A gro up of pa ti ents had ot her prob lems that may ha ve ca u sed ma lab sorp ti on such as He lico bac ter pylo ri gas tri tis (66/85= 77.6%), an ti gas tric pa ri e tal cell an ti body po si ti vity (37/85= 43.5%), an tig li a din an ti body po si ti vity (40/61= 65.6%), and ot hers (3.3%). The pa ti ent gro up with vi ta min B12 de fi ci ency con su med sig ni fi cantly less me at (p< 0.001), chic ken (p< 0.001), fish (p= 0.002), milk (p= 0.027) and eggs (p< 0.001), smaller num ber of me als (p= 0.013) and sig ni fi cantly hig her amounts of fi ber (p< 0.001) and ve ge tab les (p= 0.037) when com pa red with the con trol gro up. C Co on nc c l lu u --s si i o on n: : Vi ta min B12 de fi ci ency was con si de red to be re la ted ma inly with im pro per and de fec ti ve ali men ta ti on. Ho we ver, ma lab sorp ti on-re la ted di se a ses may al so con tri bu te to vi ta min B12 de fi ciency.K Ke ey y W Wo or rd ds s: : Vi ta min B12 de fi ci ency; nut ri ti on di sor ders, gas tri tis Ö ÖZ ZE ET T A Am ma aç ç: : Bu ça lış ma da po lik li nik has ta po pü las yo nun da B12 vi ta mi ni ek sik li ği nin özel lik leri ve ko lay laş tı rı cı fak tör le rin de ğer len di ril me si amaç lan mış tır. G Ge e r re eç ç v ve e Y Yö ön n t te em m l le er r: : Vitamin B12 ek sik li ği sap ta nan 400 has ta in ce len di. An tro po met rik öl çüm ler (boy, ki lo, beden kitle indeksi) ve bi yo kim ya sal tet kik ler, gas trik par ye tal hüc re an ti ko ru, ga i ta da pa ra zit, an tig li a din an ti kor la rı ve gas tros ko pi in ce le me le ri ya pıl dı. İla ve ten te sa dü fen se çi len, B12 dü zey le ri dü şük 100 ve B12 dü -zey le ri nor mal sağ lık lı 100'er has ta nın gı da tü ke tim le ri sor gu lan dı. B Bu ul l g gu u l la ar r: : Po lik li nik has ta ların da B12 ek sik li ği %4 ora nın da idi. Bir lik te bu lu nan has ta lık lar ola rak; di a be tes mel li tus (%12.3), hi per tan si yon (%42.0), hi per li pi de m...

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 75%

The Properties of Vitamin B12 Deficiency in the Patients of an Outpatient Clinic

Erden¹,

Şakar²,

Koç³

et al. 2010

Turkiye Klinikleri J Med Sci

View full text Add to dashboard Cite

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“…Although this question has long intrigued investigators, the relation between H pylori and the pathogenesis of PA is still unsettled. 49,50 H pylori-infected subjects have circulating IgG antibodies directed against epitopes on gastric mucosal cells. 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.…”

Section: Relation Between Autoimmune Gastritis and H Pylori Infectionmentioning

confidence: 99%

How I treat unexplained refractory iron deficiency anemia

Hershko

Camaschella

2014

Blood

138

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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“…Moreover, the canalicular antibody has Hϩ/Kϩ ATPase specificity (34). This process is one of antigenic mimicry (35). Circulating antibodies or lamina propria T cells may be the trigger for parietal cell destruction.…”

Section: Autoimmune Gastritismentioning

confidence: 99%

Gastritis and Carditis

Owen

2003

Modern Pathology

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Dyspepsia is a common clinical problem. Its causes include peptic ulcer disease, gastroesophageal reflux, and functional (nonulcer) dyspepsia. A detailed clinical description of pain does not reliably differentiate the cause. Approximately 80% of gastroscopies are performed for the investigation of dyspepsia. "Gastritis" is diagnosed endoscopically in 59% of all stomachs, although in only 3% are the changes severe. Pathologic examination of unselected gastric biopsy specimens reveals that abnormalities are present in 62-73%, but there is only a weak correlation between endoscopic and histologic findings. For these reasons, it is recommended that endoscopic examination should always be accompanied by biopsy. Ideally, biopsies should be taken in a systematic fashion to include sampling of antrum and corpus. Recent evidence suggests that gastric infection by Helicobacter pylori initially presents as a superficial gastritis. Later it may become atrophic with development of intestinal metaplasia. The onset of atrophic changes may be related to the duration of infection, the strain of the infecting organism, associated dietary factors, or as-yet undefined host factors related to immunity. Persistent superficial gastritis predisposes to duodenal ulcer and gastric mucosa-associated lymphoid tissue lymphoma. Atrophic gastritis predisposes to gastric ulcer and adenocarcinoma. Evidence is accumulating that in some patients, pernicious anemia may be an end result of H. pylori-induced atrophic gastritis. Reactive gastropathy is a relatively common finding in gastric biopsies; in most instances it is associated with either reflux of duodenal contents or therapy with nonsteroidal anti-inflammatory drugs. Lymphocytic gastritis, eosinophilic gastritis, and the gastritis associated with Crohn's disease are distinct morphologic entities. Most gastroscopies are performed for the investigation of dyspepsia (1-7). This is a common clinical problem but is rarely life-threatening. The causes of dyspepsia include peptic ulcer disease (30%), gastroesophageal reflux (29%), and nonulcer (functional) dyspepsia (40%). The cause of functional dyspepsia is unclear at the present time, although in many instances it may be related to abnormalities of gut motility. In Ͻ1% of cases is gastric cancer a cause of dyspepsia. A detailed description of the symptoms of dyspepsia does not reliably differentiate the cause, although the presence of heartburn strongly suggests a component of gastroesophageal reflux. Correlations among patient symptoms, endoscopic appearances, and biopsy findings of gastritis are imperfect (4 -6). Agreement is best in cases where peptic ulcer or another focal lesion is identified. A study by Khakoo et al. (7) from the United Kingdom illustrates the problems encountered. Endoscopic and histologic findings were reviewed in 167 patients who underwent gastroscopy for dyspeptic symptoms. Of these, 98 patients (57%) had endoscopic evidence of gastritis. In 42% of patients, gastritis involved the antrum alone, in 7% it involved the...

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Links Between Helicobacter pylori Infection, Cobalamin Deficiency, and Pernicious Anemia

Cited by 41 publications

References 18 publications

The Properties of Vitamin B12 Deficiency in the Patients of an Outpatient Clinic

The Properties of Vitamin B12 Deficiency in the Patients of an Outpatient Clinic

How I treat unexplained refractory iron deficiency anemia

Gastritis and Carditis

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