Pernicious anemia and the presence of antibodies involved in the development of this disease and other autoimmune diseases

Abstract

INTROduCTION Pernicious anemia (PA) is an autoimmune hematopoietic disease. ObjECTIvEs The aim of the study was to determine autoantibodies involved in the pathogenesis of PA and the development of other autoimmune disorders such as connective tissue diseases and celiac disease. We also aimed to assess the potential usefulness of the specific diagnostic and screening tests in patients with PA. PATIENTs ANd mEThOds The study group comprised 124 women and men with newly diagnosed PA and 41 healthy controls. Intrinsic factor (IF) antibodies, gastric parietal cell (GPC) antibodies, endomysium antibodies (EmAs), and antinuclear antibodies (ANAs) were determined in blood samples. REsuLTs IF or GPC antibodies were present in 61.3% of patients, GPC antibodies, in 46%, IF antibodies, in 30.6%, IF and GPC antibodies, in 15.3%. There was no difference in the occurrence of ANAs and EmAs between the PA and control groups. However, ANAs were found in 16.1% of patients with PA and in 4.9% of controls. The occurrence of EmAs in both groups was similar (3.2% vs 2.4%); however, it has been shown that patients with IF or GPC antibodies are more prone to be EmA positive (P = 0.009). CONCLusIONs Simultaneous determination of IF and GPC antibodies increases the chances of confirming the diagnosis of PA. Also, screening for connective tissue diseases and celiac disease may be considered in patients with PA, due to the presence of ANAs and EmAs in that population.

Antinuclear Autoantibodies in Health: Autoimmunity Is Not a Synonym of Autoimmune Disease

“…Since then, it has become one of the diagnostic criteria for SLE [7,124,125], as well as for other systemic ADs with non-organ-specific autoantibodies: systemic scleroderma [14,120,121], Sjogren's syndrome, and mixed connective tissue disease [7,23]. ANAs are also present in rheumatoid arthritis [23], autoimmune hepatitis [126], pernicious anemia associated with primary autoimmune atrophic gastritis [127], Hashimoto's thyroiditis, and immune thrombocytopenic purpura [128].…”

“…Authors of the publications from European countries (where, as mentioned above, laboratories are more likely to take higher dilutions of serum as a cutoff) usually report a rather low prevalence of ANAs in healthy populations. For example, ANAs were detected only in 4.9% of 41 healthy residents of Poland (the titer was not indicated) [127]; among blood donors in the Netherlands at the dilution of more than 1:80, the value was about 4%, although lower titers were found in 12.7% of cases [179].…”

Antinuclear Autoantibodies in Health: Autoimmunity Is Not a Synonym of Autoimmune Disease

“…Since then, it has become one of the diagnostic criteria for SLE [7,124,125], as well as for other systemic ADs with non-organspecific autoantibodies: systemic scleroderma [14,120,121], Sjogren's syndrome, and mixed connective tissue disease [7,23]. ANA also present in rheumatoid arthritis [23], autoimmune hepatitis [126], pernicious anemia associated with primary autoimmune atrophic gastritis [127], Hashimoto's thyroiditis and immune thrombocytopenic purpura [128].…”

“…Authors of the publications from European countries (where, as mentioned above, laboratories are more likely to take higher dilutions of serum as cutoff) usually report rather low prevalence of ANA in healthy population. For example, ANA was detected only in 4.9% of 41 healthy residents of Poland (the titer was not indicated) [127]. The level of AHA-positivity among blood donors in the Netherlands at the dilution of more than 1:80 was about 4%, although lower titers were found in 12.7% of cases [178].…”

Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling

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