gastrins and Lupus-Erythematosus--Systemic

Gastric carcinoid is a rare tumour that is associated with chronic atrophic gastritis in the majority of cases. It usually occurs in the 6th or 7th decade of life and is rarely diagnosed in patients under 30 years of age.. We describe a case of multiple gastric carcinoids in a 23-year-old woman with systemic lupus erythematosus and atrophic autoimmune gastritis--an association that has not been reported previously.. The combination of atrophic autoimmune gastritis and gastric carcinoid with other autoimmune disorders has rarely been reported in the English medical literature.. The fact that it mostly concerns (relatively) young patients may suggest a potential causative relation between those autoimmune disorders and the early development of atrophic gastritis with hypergastrinaemia, which subsequently leads to the occurrence of gastric carcinoid tumours at a young age.

Topics: Adult; Antiphospholipid Syndrome; Carcinoid Tumor; Female; Gastrectomy; Gastrins; Gastritis, Atrophic; Gastroscopy; Humans; Lupus Erythematosus, Systemic; Stomach; Stomach Neoplasms

We examined 51 sera from patients with pernicious anaemia for their capacity to block maximal gastrin stimulation of acid secretion by isolated rodent gastric parietal cells. 14C-aminopyrine accumulation was used as the index of acid secretion in vitro. Sera from patients with pernicious anaemia gave significantly (P less than 0.005) more block of maximal gastrin stimulation of acid secretion (61.7 +/- 37.8%) than sera from 10 patients with systemic lupus erythematosus (19.6 +/- 17.7%), 10 with scleroderma (34.2 +/- 22.3%), five with rheumatoid arthritis (22.4 +/- 15.6%) or 30 from healthy persons (27.4 +/- 12.8%). Maximal histamine stimulation of acid secretion was not inhibited. The blocking factor was present in serum IgG fractions, and serum and IgG fractions gave parallel dose-response and dilution curves. The serum block was abolished by absorption with gastric mucosal cells and correlated with the presence of parietal cell surface autoantibody. We conclude that serum immunoglobulin in pernicious anaemia can block gastrin stimulation of acid secretion and suggest that this block may be mediated by competition with gastrin for surface receptors on parietal cells.

Topics: Adult; Aged; Aminopyrine; Anemia, Pernicious; Animals; Arthritis, Rheumatoid; Autoantibodies; Binding, Competitive; Dose-Response Relationship, Immunologic; Female; Gastric Acid; Gastrins; Humans; Immunoglobulin G; In Vitro Techniques; Intrinsic Factor; Lupus Erythematosus, Systemic; Male; Middle Aged; Parietal Cells, Gastric; Rats; Rats, Inbred Strains; Scleroderma, Systemic

A significant rise in immunoreactive gastrin in a proportion of patients with rheumatoid arthritis is confirmed. Such a rise does not seem to occur in other inflammatory or tissue destructive diseases. The patients with raised immunoreactive gastrin appear to form a separate population but the factors determining this separation remain obscure. Anti-inflammatory drugs, at least during short-term administration have no influence on immunoreactive gastrin concentrations.

Topics: Adult; Aged; Anti-Inflammatory Agents; Antigens; Arthritis; Arthritis, Rheumatoid; Female; Gastrins; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Myocardial Infarction; Osteoarthritis; Psoriasis; Radioimmunoassay; Spondylitis, Ankylosing; Tuberculosis, Pulmonary