SUMMARY Five of 33 patients with dermatitis herpetiformis (DH) were found to have gastric parietal cell antibody in their sera, whereas it was not found in 30 healthy controls of comparable age distribution. Fifteen of the patients with DH underwent further studies to investigate the histological and functional state of their gastric mucosa. Atrophic gastritis was found in all five patients whose sera contained gastric parietal cell antibody and in three of 11 patients with no antibody in their sera. In addition, there was marked impairment of acid secretion in the DH group as a whole, but, apart from one patient with overt pernicious anaemia (PA), there was no evidence of malabsorption of B,2.Recent studies of patients with DH have shown marked impairment of gastric acid production in response to pentagastrin (Heading et al., 1974). The presence of gastric parietal cell antibody (Fraser, 1970) and an increased prevalence of PA in DH has been noted (Cream and Scott, 1970). These reports, together with the findings of gastric parietal cell antibody in five of our 33 patients with DH, stimulated us to investigate further these patients with regard to gastric morphology and pentagastrin stimulated acid secretion.
Methods
PATIENTSThe sera of 33 patients with DH (24 male and nine female; age range 17-73 years) and 30 healthy controls (14 male and 16 female; age range 20-71 years) were screened for gastric parietal cell antibody. Sixteen of the DH patients (13 male and three female; age range 21-77 years) consented to further investigation including a gastric biopsy, a pentagastrin test meal, and tests of B12 absorption.GASTRIC PARIETAL CELL ANTIBODY A 1 in 10 dilution of serum was examined by standard indirect immunofluorescencemethods (Seah et al., 1971) for the presence of antibodies against gastric parietal cell using cryostat sections of rat 'Requests for reprints: Dr.