Reassessment of Intrinsic Factor and Parietal Cell Autoantibodies in Atrophic Gastritis With Respect to Cobalamin Deficiency

Lahner, Edith; Norman, Gary L.; Severi, Carola; Encabo, Susan; Shums, Zakera; Vannella, Lucy; Fave, Gianfranco Delle; Annibale, Bruno

doi:10.1038/ajg.2009.231

Cited by 136 publications

(98 citation statements)

References 25 publications

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“…Another observation emerging from this case series is that all four patients with gastric cancer had well-known features of autoimmune gastritis [29,30], that is, a spared antrum, associated pernicious anemia and autoimmune thyroid disease, while in the group of patients without gastric cancer, about half had antral gastritis and autoimmune thyroid disease, and pernicious anemia was present in slightly more than 75 %. These findings raise the question of the role of autoimmune gastritis in patients with T1-GCs and gastric cancer.…”

Section: Discussionmentioning

confidence: 94%

“…Iron deficiency anemia was defined as a low hemoglobin concentration, MCV \80 fl and ferritin \30 ng/ml [28,29]. The diagnosis of autoimmune thyroid disease was based on the presence of thyroid autoantibodies and thyroiditis signs at ultrasound evaluation irrespective of thyroid function, as previously described [30].…”

Section: Diagnosis Of Type I Gastric Carcinoid and Atrophic Body Gastmentioning

confidence: 99%

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Gastric cancer in patients with type I gastric carcinoids

et al. 2014

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Background Atrophic body gastritis (ABG) is associated with both type I gastric carcinoids (T1-GCs) and intestinaltype gastric cancer. The occurrence of gastric cancer in ABG patients with type I gastric carcinoids has not yet been described. Aim To describe the occurrence at follow-up of gastric cancer in ABG patients with type I gastric carcinoid in a retrospective case series in a single tertiary referral center. Methods Between 1994 and 2012, 17 new cases of T1-GCs were diagnosed among a cohort of ABG patients in a single tertiary referral center for ABG. The clinical charts of these 17 T1-GC patients were retrospectively evaluated for the occurrence of gastric cancer at follow-up (median 4.2 years, range 0.5-13). Results In 4 (23.5 %)/17 T1-GCs patients (3 females, age 40-78 years), gastric cancer occurred (median follow-up 5.9 years, range 5.1-13). Three cases were intestinal-type adenocarcinomas and one a signet-ring cell diffuse gastric cancer, localized in three cases in the antrum. In two patients, it was detected on random biopsies during followup gastroscopy; in the other two, gastroscopy was performed because of new symptoms. All patients with gastric cancer had associated autoimmune features (pernicious anemia, autoimmune thyroid disease and a spared antrum) compared to 77, 46 and 54 % of those without gastric cancer, although statistical significance was not reached. Conclusions This case series shows that in patients with T1-GCs, gastric cancer may frequently occur at long-term follow-up. Thus, these patients should be monitored by a long-term surveillance program, including an accurate bioptic sampling of the antral mucosa.

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Section: Discussionmentioning

confidence: 94%

Section: Diagnosis Of Type I Gastric Carcinoid and Atrophic Body Gastmentioning

confidence: 99%

Gastric cancer in patients with type I gastric carcinoids

et al. 2014

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“…The relatively high frequency of ChAG might result from the population differences or more efficient screening procedures. Enzyme-linked immunosorbent assays (ELISA) are highly sensitive in PCA detection (over 85% sensitivity), and their results seem less operator dependent than in the case of immunofluorescent methods [34]. Data obtained by means of the later technique indicate 15% prevalence of serum PCA among healthy Polish persons over 85 years of age [35].…”

Section: Discussionmentioning

confidence: 98%

Screening for associated autoimmune disorders in Polish patients with Addison’s disease

Fichna

Gryczyńska

et al. 2010

Endocr

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Autoimmune Addison's disease (AAD) is the main reason of primary adrenal failure. More than a half of patients display additional autoimmune conditions, which represent a considerable clinical concern. This study aimed to investigate the prevalence of concomitant autoimmune disorders in 85 Polish AAD patients (61 females, 24 males). Mean age at AAD onset was 34.6 ± 12.6 years, significantly earlier in males (P < 0.001). Sixty-nine patients presented positive serum antibodies to 21-hydroxylase and shorter AAD duration than those with negative results (P = 0.027). Seventy-three subjects suffered from coexisting autoimmune disorders. Serum autoantibodies against thyreoperoxidase, thyroglobulin, TSH receptor, glutamic acid decarboxylase, insulin, tyrosine phosphatase-like protein IA2, parietal cell H(+)/K(+)-ATPase, intrinsic factor and tissue transglutaminase were detectable in 71.8, 41.2, 4.7, 21.0, 4.9, 2.5, 49.4, 12.0 and 3.5% of patients, respectively. Antinuclear antibodies were found in 12.5%. Thyroid autoimmunity was most common (46 subjects with lymphocytic thyroiditis, 19 with Graves' disease), followed by atrophic gastritis (29.4%), pernicious anaemia (11.8%), hypergonadotropic hypogonadism (8.2%), vitiligo (8.2%), type 1 diabetes (7.1%), celiac disease (3.5%) and alopecia (2.4%). Gender differences were observed only for thyroid autoimmunity. Current study confirms particular tendency of AAD patients to develop other autoimmune disorders. Active search for concomitant conditions is warranted to prevent serious complications.

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“…Centanni et al [22] investigated 22 patients with AIG and they reported that APA was positive in 68% (15/22) of the AIG patients. In another study, Lahner et al [23] studied 165 patients with chronic atrophic gastritis and 113 controls by means of APA and intrinsic factor antibody and found APA in 81% of patients and 10% of controls and intrinsic factor antibody in 27% of patients. APA can be found in H. pylori- related gastritis and also found in up to 10% of normal healthy subjects.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profiles, Endoscopic and Laboratory Features and Associated Factors in Patients with Autoimmune Gastritis

et al. 2012

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Background/Aims: Autoimmune gastritis (AIG) may predispose to gastric carcinoid tumors or adenocarcinomas and may also cause unexplained iron and/or vitamin B₁₂ deficiency. The aims of this study were to explore clinical manifestations, endoscopic findings and laboratory features of patients with AIG. Methods: 109 patients with AIG were enrolled into the study. In addition to demographic and clinical data, gastric lesions, serum gastrin, vitamin B₁₂, antiparietal cell antibody (APA), current Helicobacter pylori status, and anti-H. pylori IgG were also investigated. Results: The mean age of the patients was 53.06 ± 12.7 years (range 24–81; 72 (66.1%) women). The most common main presenting symptom was abdominal symptoms in 51 patients, consultation for iron and/or vitamin B₁₂ deficiency in 36, and non-specific symptoms including intermittent diarrhea in 15 patients. Endoscopic lesions were detected in 17 patients, hyperplastic polyps in 8, gastric carcinoid tumor in 4, fundic gland polyps in 3, and adenomatous polyps in 2 patients. H. pylori was negative in all patients in biopsy specimens; however, anti-H. pylori IgG was positive in 30 (27.5%) patients. 91 patients (83.4%) were positive for APA. Conclusion: In patients with AIG, the main symptoms prompted for clinical investigation were: abdominal symptoms, iron/B₁₂ deficiency and non-specific symptoms. 20% of patients with AIG had various gastric lesions including type I gastric carcinoids. None of the patients were positive for H. pylori by means of invasive tests; however, anti-H. pylori IgG was found in 27.5% of patients. Patients referring with non-specific abdominal symptoms such as bloating, diarrhea and iron/B₁₂ deficiency should be investigated for the presence of AIG.

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Reassessment of Intrinsic Factor and Parietal Cell Autoantibodies in Atrophic Gastritis With Respect to Cobalamin Deficiency

Cited by 136 publications

References 25 publications

Gastric cancer in patients with type I gastric carcinoids

Gastric cancer in patients with type I gastric carcinoids

Screening for associated autoimmune disorders in Polish patients with Addison’s disease

Clinical Profiles, Endoscopic and Laboratory Features and Associated Factors in Patients with Autoimmune Gastritis

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