Preview

Russian Journal of Gastroenterology, Hepatology, Coloproctology

Advanced search

Hematological manifestations of autoimmune gastritis

https://doi.org/10.22416/1382-4376-2016-26-1-37-43

Abstract

Aim of investigation. To estimate hematological disorders in patients with high titer of anti-parietal cell antibodies (APCA). Material and methods. Overall 71 patient with high serum APCA titer were included in original study. At all patients scores of clinical and biochemical blood tests were investigated. The special attention was given to RBC color index (CI), mean corpuscular volume (MCV), mean hemoglobin content per cell and serum iron and vitamin В12 concentration. Results. The mean indices of clinical and biochemical blood tests in APCA-positive patients were within normal range. Hematological changes were revealed in 25,4% of patients. In 11,3% of the cases either macrocytic or microcytic anemia was diagnosed. Increase in mean corpuscular volume and serum cobalamin level were found out in 16,9% of the cases, while low hemoglobin level - only at 25% of them. No Helicobacter pylori infection has been revealed in the patients with macrocytic anemia, however no significant difference on its prevalence in patients with different serum cobalamin level was found out. Conclusion. The majority of cases with high APCA titer has no hematological signs of autoimmune gastritis. In 25,4% of patients with APCA changes in common blood count were revealed, most often - of MCV and the CI. Anemia was diagnosed in 11,3% of patients. In investigated group cobalamin deficiency was found in 16,9% of patients, iron deficiency - in 9,9% of the cases. In 75% of patients increase in MCV was the only sign of cobalamin deficiency. Iron deficiency was more common in women.

About the Authors

Ye. A. Losik
«Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian Federation, Moscow
Russian Federation


V. T. Ivashkin
«Sechenov First Moscow state medical university», Ministry of Healthcare of the Russian Federation, Moscow
Russian Federation


References

1. Chanarin I. A history of pernicious anemia. Br J Haemat 2000; 111:407-41.

2. Faber K., Bloch C.E. Ueber die pathologischen Veranderungen am Digestionstractus bei der perniciosier Anamie und uber die sogenannte Darmatrophie. Ztschr f klin Med 1900; 40:98.

3. Taylor K.B., Morton J.A. An antibody to Castle’s intrinsic factor. J Path Bact 1959; 77:117.

4. Irvine W.J., Davies S.H., Teitelbaum S., Delamore I.W., Williams A.W. The clinical and pathological significance of gastric parietal cell antibody. Ann N Y Acad Sci 1965; 124:657-91.

5. Lahner E., Annibale B. Pernicious anemia: New insights from a gastroenterological point of view. World J Gastroenterol 2009; 15:5121-8.

6. Irvine W.J. Clinical and pathological significance of parietal cell antibodies. Proc R Soc Med 1966; 59:695-8.

7. Andres E., Serraj K. Optimal management of pernicious anemia. J Blood Med 2012; 3:97-103.

8. Ye W., Nyrén O. Risk of cancers of the oesophagus and stomach by histology or subsite in patients hospitalised for pernicious anaemia. Gut 2003; 52:938-41.

9. Lechner K., Födinger M., Grisold W., Püspök A., Sillaber C. Vitamin B12 deficiency. New data on an old theme. Wien Klin Wochenschr 2005; 117:579-91.

10. Oh R.C., Brown D.L. Vitamin B12 deficiency. Am Fam Physician 2003; 67:993-4.

11. Gisbert J.P., Gomollón F. A short review of malabsorption and anemia. World J Gastroenterol 2009; 15:464452.

12. Окороков А.Н. Диагностика болезней внутренних органов. Диагностика болезней системы крови. М.: Мед. Литтера; 2001.

13. Froese D.S., Gravel R.A. Genetic disorders of vitamin B12 metabolism: eight complementation groups - eight genes. Expert Rev Mol Med 2010; 12:37.

14. Beghé C., Wilson A., Ershler W.B. Prevalence and outcomes of anemia in geriatrics: a systematic review of the literature. Am J Med 2004; 116:3-10.

15. Chulilla J.A.M., Colás M.S.R., Martín M.G. Classification of anemia for gastroenterologists. World J Gastroenterol 2009; 15:4627-37.

16. Cabot R.C. Pernicious anemia (cryptogenic). A System of Medicine. London, 1908.

17. Andrès E., Vogel T., Federici L., Zimmer J., Ciobanu E., Kaltenbach G. Cobalamin deficiency in elderly patients: a personal view. Curr Gerontol Geriatr Res 2008:848267.

18. Nafil H., Tazi I., Sifessalam M., Bouchtia M., Mahmal L. Clinical, biological and therapeutic profile of anemia by vitamin B12 deficiency in the department of hematology of Marrakech (Morocco). Bull Soc Pathol Exot 2013; 106:83-8.

19. Song I.C., Lee H.J., Kim H.J., Bae S.B., Lee K.T., Yang Y.J., et. al. A multicenter retrospective analysis of the clinical features of pernicious anemia in a Korean population. J Korean Med Sci 2013; 28:200-4.

20. Carmel R. Pernicious anemia. The expected findings of very low serum cobalamin levels, anemia, and macrocytosis are often lacking. Arch Intern Med 1988; 148:1712-4.

21. Xiao S.D., Jiang S.J., Shi Y., Zhang D.Z., Hu Y.B., Liu W.Z., Yuan J.M. Pernicious anemia and type A atrophic gastritis in the Chinese. Chin Med J (Engl) 1990; 103:192-6.

22. Alonso N., Granada M.L., Salinas I., Lucas A.M., Reverter J.L., Juncà J., Oriol A., Sanmartí A. Serum pepsinogen I: an early marker of pernicious anemia in patients with type 1 diabetes. J Clin Endocrinol Metab 2005; 90:5254-8.

23. Muñoz M., Villar I., García-Erce J.A. An update on iron physiology. World J Gastroenterol 2009; 15:4617-26.

24. Wang J., Pantopoulos K. Regulation of cellular iron metabolism. Biochem J 2011; 434:365-81.

25. Bermejo F., García-López S. A guide to diagnosis of iron deficiency and iron deficiency anemia in digestive diseases. World J Gastroenterol 2009; 15:4638-43.

26. Colacci E., Pasquali A., Severi C. Exocrine gastric secretion and gastritis: pathophysiological and clinical relationships. Clin Ter 2011; 162:19-25.

27. Johnson-Wimbley T.D., Graham D.Y. Diagnosis and management of iron deficiency anemia in the 21st century. Ther Adv Gastroenterol 2011; 4:177-84

28. Воробьев С.А. Сравнительная характеристика секреторной функции желудка у больных хроническим гастритом на фоне железои В12-дефицитной анемии. VIII Международный Славяно-Балтийский научный форум. Санкт-Петербург, 2006.

29. Воробьев С.А., Соловьев В.А., Ткачев В.А. Морфологические особенности и секреторная функция желудка у больных хроническим атрофическим гастритом, ассоциированным с В12-дефицитной и железодефицитной анемией. Гастроэнтерология Санкт-Петербурга 2007; 1:23.

30. Hershko C., Hoffbrand A.V., Keret D., Souroujon M., Maschler I., Monselise Y., Lahad A. Role of autoimmune gastritis, Helicobacter pylori and celiac disease in refractory or unexplained iron deficiency anemia. Haematologica 2005; 90:585-95.

31. Marignani M., Delle Fave G., Mecarocci S., Bordi C., Angeletti S., D’Ambra G., et al. High prevalence of atrophic body gastritis in patients with unexplained microcytic and macrocytic anemia: a prospective screening study. Am J Gastroenterol 1999; 94:766-72.

32. Hershko C., Patz J., Ronson A. The anemia of achylia gastrica revisited. Blood Cells Mol Dis 2007; 39:178-83.


Review

For citations:


Losik Ye.A., Ivashkin V.T. Hematological manifestations of autoimmune gastritis. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2016;26(1):37-43. (In Russ.) https://doi.org/10.22416/1382-4376-2016-26-1-37-43

Views: 2127


ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)