A study of parietal cell and intrinsic factor antibodies in B12 deficiency anaemias: a non–gastroscopic descriptive analysis in a University teaching hospital, India

Chandrasekhar Chodimella; Pasupuleti Santhosh Kumar; Roopa Naik Sugali; Marthyaya Sumanth Kumar; Potukuchi Venkata Gurunadha Krishna Sarma

Volume : VII, Issue : II, February - 2018

A study of parietal cell and intrinsic factor antibodies in B12 deficiency anaemias: a non–gastroscopic descriptive analysis in a University teaching hospital, India

Chandrasekhar Chodimella, Pasupuleti Santhosh Kumar, Roopa Naik Sugali, Marthyaya Sumanth Kumar, Potukuchi Venkata Gurunadha Krishna Sarma

Abstract :

Background: The relationship between B12 deficiency and intrinsic factor antibody (IFA) and parietal cell antibody (PCA) was strongly established. A non–gastroscopic (non–invasive) analysis of the relationship is of great benefit.

Materials and methods: On the basis of serum B12, serum homocysteine, complete response to B12 therapy and BCSH guidelines, 120 patients were diagnosed to have IFA Positive Pernicious anemia (IFAPosPA) and IFA Negative Pernicious anemia (IFANegPA). The IFANegPA group was further divided into (PCA+ve) and (PCA–ve) subgroups. The IFA+ve(PCA+ve), IFA–ve (PCA+ve) and IFA–ve (PCA–ve) groups were studied with reference to the usual biomedical parameters.

Results: The mean serum B12 and homocystine levels were 180 pg/mL, 31 �mol/L respectively. 95% non–vegetarians, mean age 38 yrs, and female preponderance were observed. Serum homocysteine levels were normal in 21/120(17.5%) of patients in the background of sever iron deficiency. IFA+ve PA patients were 39/120 (32.5%), and IFA–ve PA group patients were 81/120 (67.5%), and patients with IFA–ve (PCA+ve) were 33/120 (27.5%). Patients with antibody positivity either IFA or only (PCA) were 72(60%), and IFA–ve (PCA–ve) (antibody negative) patients were 40%. There were significant differences in the B12, and homocysteine levels between antibody positive and negative groups.

Conclusion: 1) In the context of B12 deficiency, after excluding other non–immune causes a) IFA Pos PA patients showed more abnormal B12 and homocysteine levels than IFA Neg PA patients b) (PCA +ve) subgroup patients showed more significant B12 deficiency than (PCA–ve) patients , and both a,b may be indicating disease of longer duration or more severity. 2) PCA did not seem to have relevance in 72.5% of the cases with regards to the diagnosis of etiology of B12 deficiency or the diagnosis of PA.