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The anemia of achylia gastrica revisited.
Blood Cells Mol Dis. 2007 Sep-Oct; 39(2):178-83.BC

Abstract

Autoimmune atrophic gastritis is encountered in 20-27% of patients with obscure, or refractory iron deficiency anemia and is 4 to 6 times more common than celiac disease causing unexplained iron deficiency. The unique clinical features of iron deficiency anemia associated with achlorhydria and mucosal atrophy sparing the gastric antrum have all been accurately described by Faber and others over 100 years ago, including its refractoriness to oral iron treatment, female predominance, relatively young age, increased prevalence of thyroid disease and tendency to progress to pernicious anemia. A significant new development is the relation between autoimmune gastritis and Helicobacter pylori infection. H. pylori per se impairs gastric acid secretion and it is quite likely that a proportion of patients described originally as achylia gastrica represented H. pylori and not autoimmune gastritis. The demonstration of H. pylori antibodies in atrophic gastritis directed against epitopes on gastric mucosal cells implies an autoimmune mechanism triggered by H. pylori and directed against gastric parietal cells by antigenic mimicry of H+K+-ATPase, the most common autoantigen in pernicious anemia. These findings introduce a new element into the 100-year-old saga of achylia gastrica and open new options for its prevention and management.

Authors+Show Affiliations

Department of Hematology, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Israel. hershko@szmc.org.ilNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17493846

Citation

Hershko, Chaim, et al. "The Anemia of Achylia Gastrica Revisited." Blood Cells, Molecules & Diseases, vol. 39, no. 2, 2007, pp. 178-83.
Hershko C, Patz J, Ronson A. The anemia of achylia gastrica revisited. Blood Cells Mol Dis. 2007;39(2):178-83.
Hershko, C., Patz, J., & Ronson, A. (2007). The anemia of achylia gastrica revisited. Blood Cells, Molecules & Diseases, 39(2), 178-83.
Hershko C, Patz J, Ronson A. The Anemia of Achylia Gastrica Revisited. Blood Cells Mol Dis. 2007 Sep-Oct;39(2):178-83. PubMed PMID: 17493846.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The anemia of achylia gastrica revisited. AU - Hershko,Chaim, AU - Patz,Julian, AU - Ronson,Aharon, Y1 - 2007/05/09/ PY - 2007/03/20/received PY - 2007/03/25/accepted PY - 2007/5/12/pubmed PY - 2007/9/21/medline PY - 2007/5/12/entrez SP - 178 EP - 83 JF - Blood cells, molecules & diseases JO - Blood Cells Mol Dis VL - 39 IS - 2 N2 - Autoimmune atrophic gastritis is encountered in 20-27% of patients with obscure, or refractory iron deficiency anemia and is 4 to 6 times more common than celiac disease causing unexplained iron deficiency. The unique clinical features of iron deficiency anemia associated with achlorhydria and mucosal atrophy sparing the gastric antrum have all been accurately described by Faber and others over 100 years ago, including its refractoriness to oral iron treatment, female predominance, relatively young age, increased prevalence of thyroid disease and tendency to progress to pernicious anemia. A significant new development is the relation between autoimmune gastritis and Helicobacter pylori infection. H. pylori per se impairs gastric acid secretion and it is quite likely that a proportion of patients described originally as achylia gastrica represented H. pylori and not autoimmune gastritis. The demonstration of H. pylori antibodies in atrophic gastritis directed against epitopes on gastric mucosal cells implies an autoimmune mechanism triggered by H. pylori and directed against gastric parietal cells by antigenic mimicry of H+K+-ATPase, the most common autoantigen in pernicious anemia. These findings introduce a new element into the 100-year-old saga of achylia gastrica and open new options for its prevention and management. SN - 1079-9796 UR - https://www.unboundmedicine.com/medline/citation/17493846/The_anemia_of_achylia_gastrica_revisited_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1079-9796(07)00073-3 DB - PRIME DP - Unbound Medicine ER -