Tags

Type your tag names separated by a space and hit enter

Limited value of testing for intrinsic factor antibodies with negative gastric parietal cell antibodies in pernicious anaemia.
J Clin Pathol. 2009 May; 62(5):439-41.JC

Abstract

BACKGROUND

The appropriate testing strategy for diagnosing pernicious anaemia using gastric parietal cell (GPC) and/or intrinsic factor antibodies (IFA) is controversial. Intrinsic factor antibodies are found in only about 70% of cases. Indirect immunofluorescence screening for gastric parietal cell antibodies is more sensitive, labour intensive, and less specific.

METHODS

The frequency of antibody positivity (IFA and/or GPC) was retrospectively examined in patients tested for both autoantibodies over a three-year period. It was investigated whether B12 levels were related to antibody status. These findings were validated in a prospective study of IFA in 91 GPC negative patients with low B12 levels.

RESULTS

Of 847 samples identified in the retrospective study, 4 (0.47%) were positive for only intrinsic factor antibodies, 731 (86.3%) positive for GPC alone, and 112 (13.2%) for both. Student t test on log-transformed data showed B12 levels had no bearing on autoantibody status. 91 consecutive patients with low B12 levels were tested for both autoantibodies; all were negative for gastric parietal cell antibodies. Only one sample was positive for intrinsic factor antibody using the porcine intrinsic factor assay, but was negative by a human recombinant intrinsic factor-based ELISA.

CONCLUSIONS

This study provides evidence that testing for gastric parietal cell antibodies is an appropriate screening test for pernicious anaemia, with intrinsic factor antibodies reserved for confirmatory testing or in patients with other autoantibodies that mask the GPC pattern; B12 levels are not related to autoantibody status.

Authors+Show Affiliations

Path Links Immunology, Scunthorpe General Hospital, Scunthorpe, UK. sujoykhan@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19398595

Citation

Khan, S, et al. "Limited Value of Testing for Intrinsic Factor Antibodies With Negative Gastric Parietal Cell Antibodies in Pernicious Anaemia." Journal of Clinical Pathology, vol. 62, no. 5, 2009, pp. 439-41.
Khan S, Del-Duca C, Fenton E, et al. Limited value of testing for intrinsic factor antibodies with negative gastric parietal cell antibodies in pernicious anaemia. J Clin Pathol. 2009;62(5):439-41.
Khan, S., Del-Duca, C., Fenton, E., Holding, S., Hirst, J., Doré, P. C., & Sewell, W. A. (2009). Limited value of testing for intrinsic factor antibodies with negative gastric parietal cell antibodies in pernicious anaemia. Journal of Clinical Pathology, 62(5), 439-41. https://doi.org/10.1136/jcp.2008.060509
Khan S, et al. Limited Value of Testing for Intrinsic Factor Antibodies With Negative Gastric Parietal Cell Antibodies in Pernicious Anaemia. J Clin Pathol. 2009;62(5):439-41. PubMed PMID: 19398595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Limited value of testing for intrinsic factor antibodies with negative gastric parietal cell antibodies in pernicious anaemia. AU - Khan,S, AU - Del-Duca,C, AU - Fenton,E, AU - Holding,S, AU - Hirst,J, AU - Doré,P C, AU - Sewell,W A C, PY - 2009/4/29/entrez PY - 2009/4/29/pubmed PY - 2009/9/29/medline SP - 439 EP - 41 JF - Journal of clinical pathology JO - J Clin Pathol VL - 62 IS - 5 N2 - BACKGROUND: The appropriate testing strategy for diagnosing pernicious anaemia using gastric parietal cell (GPC) and/or intrinsic factor antibodies (IFA) is controversial. Intrinsic factor antibodies are found in only about 70% of cases. Indirect immunofluorescence screening for gastric parietal cell antibodies is more sensitive, labour intensive, and less specific. METHODS: The frequency of antibody positivity (IFA and/or GPC) was retrospectively examined in patients tested for both autoantibodies over a three-year period. It was investigated whether B12 levels were related to antibody status. These findings were validated in a prospective study of IFA in 91 GPC negative patients with low B12 levels. RESULTS: Of 847 samples identified in the retrospective study, 4 (0.47%) were positive for only intrinsic factor antibodies, 731 (86.3%) positive for GPC alone, and 112 (13.2%) for both. Student t test on log-transformed data showed B12 levels had no bearing on autoantibody status. 91 consecutive patients with low B12 levels were tested for both autoantibodies; all were negative for gastric parietal cell antibodies. Only one sample was positive for intrinsic factor antibody using the porcine intrinsic factor assay, but was negative by a human recombinant intrinsic factor-based ELISA. CONCLUSIONS: This study provides evidence that testing for gastric parietal cell antibodies is an appropriate screening test for pernicious anaemia, with intrinsic factor antibodies reserved for confirmatory testing or in patients with other autoantibodies that mask the GPC pattern; B12 levels are not related to autoantibody status. SN - 1472-4146 UR - https://www.unboundmedicine.com/medline/citation/19398595/Limited_value_of_testing_for_intrinsic_factor_antibodies_with_negative_gastric_parietal_cell_antibodies_in_pernicious_anaemia_ L2 - https://jcp.bmj.com/lookup/pmidlookup?view=long&pmid=19398595 DB - PRIME DP - Unbound Medicine ER -