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Do all the patients with gastric parietal cell antibodies have pernicious anemia?
Insights
Only a small fraction of patients with gastric parietal cell antibodies have pernicious anemia. Further investigation is needed to understand the implications of these antibodies in individuals without pernicious anemia.
Area of Science:
- Gastroenterology
- Hematology
- Immunology
Background:
- Serum gastric parietal cell antibodies (GPCA) are associated with autoimmune conditions.
- Pernicious anemia (PA) is a condition characterized by vitamin B12 deficiency due to autoimmune gastritis.
- The relationship between GPCA positivity and the prevalence of PA requires further clarification.
Purpose of the Study:
- To determine the proportion of GPCA-positive patients who meet the diagnostic criteria for pernicious anemia.
- To investigate the prevalence of hematological abnormalities in GPCA-positive individuals.
Main Methods:
- Blood samples from 124 GPCA-positive patients and 124 healthy controls were analyzed.
- Measurements included hemoglobin (Hb), iron, vitamin B12 levels, and mean corpuscular volume (MCV).
- Pernicious anemia was defined using WHO criteria: low Hb, high MCV, and low vitamin B12.
Main Results:
- GPCA-positive patients showed significantly higher rates of Hb, iron, and vitamin B12 deficiencies compared to controls (P < 0.001).
- A notable percentage of GPCA-positive patients exhibited high MCV (≥ 100 fl).
- Only 12.9% of GPCA-positive patients were diagnosed with pernicious anemia based on WHO criteria.
Conclusions:
- The presence of GPCA alone is not sufficient for diagnosing pernicious anemia.
- A significant number of GPCA-positive individuals have hematological abnormalities without meeting the full criteria for PA.
- Further research is warranted to understand the clinical significance of GPCA in the absence of overt PA.
Objective:
This study evaluated whether all the patients with serum gastric parietal cell antibody (GPCA) positivity had pernicious anemia (PA).
Materials And Methods:
The blood hemoglobin (Hb), iron, and vitamin B12 concentrations, and mean corpuscular volume (MCV) in 124 GPCA-positive patients were measured and compared with the corresponding data in 124 age- and sex-matched healthy controls. PA was defined by World Health Organization (WHO) as having an Hb concentration < 13 g dl(-1) for men and < 12 g dl(-1) for women, an MCV ≥ 100 fl, and a serum vitamin B12 level < 200 pg ml(-1) .
Results:
We found that 20, 25, and 20 GPCA-positive patients had deficiencies of Hb (men < 13 g dl(-1) , women < 12 g dl(-1) ), iron (<60 μg dl(-1) ), and vitamin B12 (<200 pg ml(-1) ), respectively. Moreover, 16 GPCA-positive patients had abnormally high MCV (≥ 100 fl). GPCA-positive patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency and of abnormally high MCV (all P-values < 0.001) than healthy controls. However, only 12.9% of 124 GPCA-positive patients were diagnosed as having PA by the WHO definition.
Conclusion:
Only 12.9% of GPCA-positive patients are discovered to have PA by the WHO definition.
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