intrinsic-factor and Autoimmune-Diseases

Autoimmune gastritis (AG) is a corpus-restricted chronic atrophic gastritis associated with intrinsic factor deficiency, either with or without pernicious anemia. Autoimmune gastritis is a microscopic disease because patients present with no or vague symptoms, and clinicians rarely find endoscopic changes. Autoimmune gastritis only becomes a clinical disease when pathologists diagnose it in gastric biopsies performed for a variety of clinical indications. Unfamiliarity with this disease can result in misdiagnosis of patients, and thus inadequate patient management.. To review the pathogenesis, clinical features, diagnostic criteria, differential diagnoses, sequelae, and surveillance recommendations for AG.. The sources of the study include a review of the pertinent literature for AG.. Autoimmune gastritis is an important disease characterized by a loss of oxyntic mucosa and presence of metaplastic epithelium and enterochromaffin-like cell hyperplasia. Awareness and proper diagnosis are critical to prevent mismanagement of patients.

Topics: Anemia, Pernicious; Autoimmune Diseases; Biopsy; Chronic Disease; Diagnosis, Differential; Diagnostic Errors; Epithelium; Gastritis, Atrophic; Humans; Hyperplasia; Intrinsic Factor; Metaplasia; Stomach

Autoimmune diseases, characterized by an alteration of the immune system which results in a loss of tolerance to self antigens often coexist in the same patient. Autoimmune atrophic gastritis, characterized by the development of antibodies agains parietal cells and against intrinsic factor, leads to mucosal destruction that affects primarily the corpus and fundus of the stomach. Autoimmune atrophic gastritis is frequently found in association with thyroid disease, including Hashimoto's thyroiditis, and with type 1 diabetes mellitus, Other autoimmune conditions that have been described in association with autoimmune atrophic gastritis are Addison's disease, chronic spontaneous urticaria, myasthenia gravis, vitiligo, and perioral cutaneous autoimmune conditions, especially erosive oral lichen planus. Interestingly, however, celiac disease, another frequent autoimmune condition, seems to play a protective role for autoimmune atrophic gastritis. The elevated prevalence of autoimmune disease clustering should prompt the clinicial to exclude concomitant autoimmune conditions upon diagnosis of any autoimmune disease.

Topics: Autoantibodies; Autoantigens; Autoimmune Diseases; Biomarkers; Comorbidity; Disease Susceptibility; Gastrins; Gastritis, Atrophic; Humans; Intrinsic Factor; Parietal Cells, Gastric; Pepsinogens; Prevalence; Sensitivity and Specificity

Human autoimmune gastritis is an organ-specific autoimmune disease of the stomach. It is characterized by the development of disease-specific autoantibodies and a pathology that specifically targets specialized cells within the gastric environment. The autoantigens associated with this disease have been defined as the gastric H+/K+ ATPase and intrinsic factor. The development of experimental disease models has been pivotal in our contemporary understanding of autoimmunity. Here we review mouse models of autoimmune gastritis and their relevance to human autoimmune gastritis associated with pernicious anemia. We appraise some historical as well as recent studies of experimental autoimmune gastritis (EAG), highlighting key findings that have formed the basis of our current understanding of the etiology and mechanism(s) associated with autoimmune gastritis. A precise understanding of the pathogenesis of autoimmune gastritis will permit the design of innovative and rational therapeutic strategies to prevent, arrest, ameliorate or reverse the disease.

Topics: Anemia, Pernicious; Animals; Autoimmune Diseases; Disease Models, Animal; Gastritis; H(+)-K(+)-Exchanging ATPase; Intrinsic Factor; Mice; Mice, Inbred C3H; Parietal Cells, Gastric

Combined medullary sclerosis developed suddenly postoperatively in a patient with unknown Biermer's disease. The neurological lesions were undoubtedly induced by nitrogen protoxide via an inactivation of vitamin B12.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Abscess; Aged; Anemia, Pernicious; Anesthetics, Inhalation; Arthroplasty, Replacement, Hip; Atrophy; Autoantibodies; Autoimmune Diseases; Demyelinating Diseases; Female; Gastric Mucosa; Humans; Intestinal Absorption; Intrinsic Factor; Nitrous Oxide; Oxidation-Reduction; Paresthesia; Postoperative Complications; Proprioception; S-Adenosylmethionine; Sclerosis; Spinal Cord; Spinal Cord Diseases; Surgical Wound Infection; Vitamin B 12

Surgical procedures that lower portal pressure, such as portacaval shunts, prevent variceal hemorrhage. Portal hypertension is the result of increased flow and increased resistance in the portal system. Pharmacologic therapy is aimed at altering these factors by the use of vasoconstrictors to reduce flow and vasodilators to decrease resistance. The current status of pharmacologic agents to achieve these effects is reviewed.

Topics: Anemia, Pernicious; Autoimmune Diseases; Cell Membrane Permeability; Gastric Mucosa; Humans; Ileum; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Metabolic Diseases; Transcobalamins; Vitamin B 12; Zollinger-Ellison Syndrome

Topics: Addison Disease; Adolescent; Anemia, Pernicious; Antigen-Antibody Reactions; Autoimmune Diseases; Candidiasis, Chronic Mucocutaneous; Celiac Disease; Child; Child, Preschool; Collagen Diseases; Endocrine System Diseases; Female; Gastritis, Atrophic; Germ Cells; Glucagon; Hepatitis B; Humans; Hypogonadism; Hypoparathyroidism; Immunologic Deficiency Syndromes; Intrinsic Factor; Male; Mast Cells; Microsomes; Organ Specificity; Receptors, Cell Surface; Receptors, Cholinergic; Thyroglobulin

Topics: Adrenal Cortex Hormones; Anemia, Pernicious; Animals; Antigen-Antibody Complex; Antigens; Autoantibodies; Autoimmune Diseases; Chronic Disease; Dogs; Female; Gastric Mucosa; Gastrins; Gastritis; Guinea Pigs; Haplorhini; Humans; Immunity, Cellular; Intrinsic Factor; Male; Rabbits; Rats; Vitamin B 12 Deficiency

Topics: Adrenal Cortex Hormones; Adult; Anemia, Pernicious; Atrophy; Autoantibodies; Autoimmune Diseases; Binding Sites, Antibody; Child; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Immunity, Cellular; Immunoglobulin A; Immunoglobulin G; Intrinsic Factor; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Celiac Disease; Colitis, Ulcerative; Crohn Disease; Fluorescent Antibody Technique; Gastritis; Gastrointestinal Diseases; Glutens; Humans; Hypersensitivity; Immunoglobulin G; Intrinsic Factor; Vitamin B 12

Topics: Adult; Agammaglobulinemia; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Female; Gastric Juice; Humans; Immunity, Cellular; Infant, Newborn; Intrinsic Factor; Male; Middle Aged; Steroids; Stomach; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Atrophy; Autoimmune Diseases; Capillaries; Chronic Disease; Dyspepsia; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Hypertrophy; Intrinsic Factor; Metaplasia; Mitosis; Pentagastrin; Pepsin A; Peptic Ulcer; Pyloric Antrum; Radiography; Stomach; Stomach Neoplasms; Thyroid Diseases; Vagotomy

Topics: Anemia, Pernicious; Animals; Antibodies; Autoimmune Diseases; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Thyroid Diseases

Topics: Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Gastric Mucosa; Intrinsic Factor; Steroids; Thyroid Gland

Topics: Anemia; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; gamma-Globulins; Humans; Immunoglobulin G; Intrinsic Factor

Topics: Anemia, Pernicious; Antibody Formation; Autoimmune Diseases; Clinical Trials as Topic; Cobalt Isotopes; Gastrectomy; Gastric Juice; Humans; Intrinsic Factor; Vitamin B 12

Pernicious anemia (PA) is an autoimmune hematopoietic disease.. The aim of the study was to determine autoantibodies involved in the pathogenesis of PA and the development of other autoimmune disorders such as connective tissue diseases and celiac disease. We also aimed to assess the potential usefulness of the specific diagnostic and screening tests in patients with PA.. The study group comprised 124 women and men with newly diagnosed PA and 41 healthy controls. Intrinsic factor (IF) antibodies, gastric parietal cell (GPC) antibodies, endomysium antibodies (EmAs), and antinuclear antibodies (ANAs) were determined in blood samples.. IF or GPC antibodies were present in 61.3% of patients, GPC antibodies, in 46%, IF antibodies, in 30.6%, IF and GPC antibodies, in 15.3%. There was no difference in the occurrence of ANAs and EmAs between the PA and control groups. However, ANAs were found in 16.1% of patients with PA and in 4.9% of controls. The occurrence of EmAs in both groups was similar (3.2% vs 2.4%); however, it has been shown that patients with IF or GPC antibodies are more prone to be EmA positive (P = 0.009).. Simultaneous determination of IF and GPC antibodies increases the chances of confirming the diagnosis of PA. Also, screening for connective tissue diseases and celiac disease may be considered in patients with PA, due to the presence of ANAs and EmAs in that population.

Topics: Adult; Aged; Anemia, Pernicious; Antibodies, Antinuclear; Autoantibodies; Autoimmune Diseases; Female; Humans; Intrinsic Factor; Male; Middle Aged

Patients with autoimmune gastritis (AIG) are reported to have an increased risk of developing gastric cancer (GC). In this study, we assess the characteristics and outcomes of GC patients with AIG in a multicenter case-control study.. Between April 2013 and May 2017, patients with GC, including cancers of the esophagogastric junction (EGJ) Siewert type II and III, were recruited. Patients with histological characteristics of AIG were identified and matched in a 1:2 fashion for age and gender to GC patients with no AIG. Presenting symptoms were documented using a self-administered questionnaire.. Pernicious anemia leads to earlier diagnosis of GC in AIG patients and contributes significantly to a better clinical outcome.

Topics: Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Case-Control Studies; Endoscopy, Digestive System; Female; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Risk Assessment; Risk Factors; Stomach Neoplasms

In the diagnostic work up of autoimmune gastritis several immunological methods are available for the detection of antibodies against Intrinsic Factor (IF) and Parietal Cells (PC). However, there are no recent reports directly comparing all the available assays and methods. The objective of this study was to compare the performance of several commercially available anti-IF and anti-PC antibody assays from different manufacturers in a multi-center multi-cohort setting.. Sera were used from 5 different cohorts consisting of samples from 25 healthy elderly, 20 HCV or HIV positive patients and 150 patients positive for anti-IF or anti-PC antibodies or in whom these antibodies were requested. These cohorts were tested for anti-IF antibodies with 6 different assays (IIF, ELISA, DIA and EliA) and for anti-PC antibodies with 7 different assays (IIF, ELISA, DIA and EliA). Performance was evaluated by calculating the concordance and relative sensitivity and specificity.. Good concordance was found between the assays for both antibody specificities, ranging from 81 to 100% and 91-100% for anti-IF and anti-PC antibodies, respectively. Highest relative sensitivity was found with the (automated) ELISA based methods. However, all assays had a relative sensitivity between 85 and 100% for anti-IF antibodies and between 95 and 100% for anti-PC antibodies. The relative specificity ranged between 76 and 100% for anti-IF antibodies and between 96 and 100% for anti-PC antibodies.. We conclude that most assays perform well and are concordant to each other, despite the methodological differences and the different sources of antigen used. However, the method used affects the sensitivity and specificity. The (automated) ELISA based assays have the highest relative sensitivity and relative specificity. Care should be taken in the interpretation of positive results by IIF and negative results by the Blue Diver when testing for anti-IF antibodies.

Topics: Autoantibodies; Autoimmune Diseases; Biomarkers; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Fluorescent Antibody Technique, Indirect; Gastritis; Humans; Immunoassay; Intrinsic Factor; Netherlands; Parietal Cells, Gastric; Predictive Value of Tests; Reproducibility of Results; Serologic Tests

The bacteria. To measure the immune reactivity of. Using enzyme-linked immunosorbent assay (ELISA) methodology, specific antibodies made against. At 3 SD above the mean of control wells coated with HSA or 0.41 OD, the mouse monoclonal antibody made against. Our findings indicate that

Topics: Antibodies, Bacterial; Autoimmune Diseases; Autoimmunity; Bacterial Toxins; Campylobacter Infections; Campylobacter jejuni; Cholera Toxin; Cross Reactions; Dietary Proteins; Haptoglobins; Host Microbial Interactions; Human Growth Hormone; Humans; Intrinsic Factor; Protein Precursors

Topics: Adult; Autoimmune Diseases; Diagnosis, Differential; Female; HELLP Syndrome; Humans; Intrinsic Factor; Pregnancy; Vitamin B 12 Deficiency

Pernicious anaemia is an autoimmune disease caused by intrinsic factor antibody; it leads to vitamin B12 deficiency and is marked by ineffective erythropoiesis. Haematological features reveal macrocytosis, hyperchromasia and hypersegmented neutrophils. Schistocytes are typically seen in microangiopathy, such as in thrombotic thrombocytopaenic purpura (TTP)/haemolytic uraemic syndrome or disseminated intravascular haemolysis (DIC). We report a case of a patient with severe anaemia who presented to the emergency room. Peripheral smear revealed macrocytosis, hypersegmented neutrophils and marked schistocytosis. The patient also had high reticulocyte count with high serum lactate dehydrogenase, elevated D-dimer, low fibrinogen and low haptoglobin. Vitamin B12 level came back low and the presence of intrinsic factor antibody confirmed pernicious anaemia. ADAMTS13 level was noted to be mildly reduced, which raised the suspicion of the association of acquired TTP with pernicious anaemia. Acquired TTP is another autoimmune disorder and its association with pernicious anaemia needs further evaluation.

Topics: ADAM Proteins; ADAMTS13 Protein; Aged; Anemia, Macrocytic; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Erythrocyte Count; Erythrocytes, Abnormal; Erythropoiesis; Female; Fibrin Fibrinogen Degradation Products; Fibrinogen; Haptoglobins; Hemolytic-Uremic Syndrome; Humans; Intrinsic Factor; L-Lactate Dehydrogenase; Neutrophils; Purpura, Thrombotic Thrombocytopenic; Vitamin B 12

Parietal cell antibody is a marker for autoimmune gastritis. With identification of gastric H/K ATPase as its molecular target, ELISAs have been introduced. We compared performance of ELISA with immunofluorescence in a retrospective and prospective sera set and correlated the results with intrinsic factor antibody. In 138 retrospective sera selected for positivity or negativity for intrinsic factor antibody, 87 reacted with gastric H/K ATPase by Euroimm ELISA but only 62 reacted by immunofluorescencence.. Similar results were obtained with Inova ELISA with 78 positives that were also positive by Euroimm ELISA. In 161 prospective sera, 29 sera tested positive by ELISA compared to 24 by immunofluorescence. ELISA positive but immunofluoresnce negative sera are bona fide positives because a representative set of 16 sera reacted with both 95kD α and 60-90kDβ subunits of gastric H/K ATPase. ELISA values rose with age regardless of whether immunofluorescence tests were positive or negative. Of 53 sera containing antibody to intrinsic factor, 46/53 (87%) reacted to gastric H/K ATPase by ELISA. Taken together, the data indicates an enhanced detection rate by ELISA over immunofluorescence and validates it as a robust diagnostic assay for parietal cell antibody. As parietal cell antibody marks asymptomatic autoimmune gastritis that may progress to end stage gastric atrophy and haematological complications, and as autoimmune gastritis is associated with autoimmune thyroiditic and type 1 diabetes mellitus, early detection of parietal cell antibody by a sensitive ELISA will enable early follow-up of at risk subjects.

Topics: Adult; Age Factors; Aged; Aged, 80 and over; Autoantibodies; Autoimmune Diseases; Enzyme-Linked Immunosorbent Assay; Erythrocytes, Abnormal; Female; Fluorescent Antibody Technique; Gastritis; H(+)-K(+)-Exchanging ATPase; Hematologic Diseases; Humans; Intrinsic Factor; Male; Middle Aged; Parietal Cells, Gastric; Retrospective Studies; Vitamin B 12 Deficiency; Young Adult

To assess the predictive value for chronic autoimmune gastritis (AIG) of the combined assay of anti-parietal-cell antibodies (PCA), anti-intrinsic-factor antibodies (IFA), anti-Helicobacter pylori (Hp) antibodies, and measurement of blood gastrin.. We studied 181 consecutive patients with anemia, due to iron deficiency resistant to oral replacement therapy or to vitamin B12 deficiency.. 83 patients (45.8%) tested positive for PCA and underwent gastroscopy with multiple gastric biopsies. On the basis of the histological diagnosis, PCA-positive patients were divided into 4 groups: (1) 30 patients with chronic atrophic gastritis; they had high concentrations of PCA and gastrin and no detectable IFA; (2) 14 subjects with metaplastic gastric atrophy; they had high PCA, IFA, and gastrin; (3) 18 patients with nonspecific lymphocytic inflammation with increased PCA, normal gastrin levels, and absence of IFA; (4) 21 patients with multifocal atrophic gastritis with "borderline" PCA, normal gastrin, absence of IFA and presence of anti-Hp in 100% of the cases.. The assay of four serological markers proved particularly effective in the diagnostic classification of gastritis and highly correlated with the histological profile. As such, this laboratory diagnostic profile may be considered an authentic "serological biopsy."

Topics: Aged; Antibodies; Autoimmune Diseases; Biopsy; Female; Gastrins; Gastritis, Atrophic; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Intrinsic Factor; Lymphocytes; Male; Middle Aged; Parietal Cells, Gastric; Serologic Tests

Topics: Anemia, Megaloblastic; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Folic Acid Deficiency; Gastritis, Atrophic; Humans; Intrinsic Factor; Parietal Cells, Gastric; Vitamin B 12; Vitamin B 12 Deficiency

To study the association between Helicobacter pylori (H. pylori) infection and autoimmune type atrophic gastritis.. Twenty-three patients with different grades of atrophic gastritis were analysed using enzyme immunoassay-based serology, immunoblot-based serology, and histology to reveal a past or a present H. pylori infection. In addition, serum markers for gastric atrophy (pepsinogen I, pepsinogen I/II and gastrin) and autoimmunity [parietal cell antibodies (PCA), and intrinsic factor (IF), antibodies] were determined.. Of the 14 patients with severe gastric atrophy, as demonstrated by histology and serum markers, and no evidence for an ongoing H. pylori infection, eight showed H. pylori antibodies by immunoblotting. All eight had elevated PCA and 4/8 also had IF antibodies. Of the six immunoblot-negative patients with severe corpus atrophy, PCA and IF antibodies were detected in four. Among the patients with low to moderate grade atrophic gastritis (all except one with an ongoing H. pylori infection), serum markers for gastric atrophy and autoimmunity were seldom detected. However, one H. pylori negative patient with mild atrophic gastritis had PCA and IF antibodies suggestive of a pre-atrophic autoimmune gastritis.. Signs of H. pylori infection in autoimmune gastritis, and positive autoimmune serum markers in H. pylori gastritis suggest an etiological role for H. pylori in autoimmune gastritis.

Topics: Aged; Autoantibodies; Autoimmune Diseases; Biomarkers; Female; Gastrins; Gastritis, Atrophic; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Humans; Immunoblotting; Immunoenzyme Techniques; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Parietal Cells, Gastric; Pepsinogen A; Pepsinogen C; Risk Factors; Severity of Illness Index; Vitamin B 12 Deficiency

Homocysteine is a risk factor for the development of thromboembolic disorders and vascular diseases. Furthermore, complications during pregnancy have been ascribed to hyperhomocysteinemia. We report on a pregnant woman being substituted by high doses folic acid for hyperhomocysteinemia. Thereby, the underlying pernicious anemia was masked. After birth, the neonate was exclusively breastfed. At the age of 5 months, the infant had to be admitted to hospital due to severe vitamin B(12)-deficiency. Using parenteral vitamin B(12) substitution, homocystein levels of the mother normalized and the infant throve and prospered again.

Topics: Abortion, Habitual; Adult; Anemia, Pernicious; Autoimmune Diseases; Breast Feeding; Diagnosis, Differential; Failure to Thrive; Female; Folic Acid; Gastritis, Atrophic; Homocysteine; Humans; Infant; Intrinsic Factor; Methylmalonic Acid; Parietal Cells, Gastric; Pregnancy; Thromboembolism; Vitamin B 12 Deficiency

Researchers have developed murine lymphopenic, non-lymphopenic, transgenic, spontaneous and infectious agent based models to induce an experimental autoimmune gastritis (EAG) for the study of human organ-specific autoimmune disease. These models result in a chronic inflammatory mononuclear cell infiltrate in the gastric mucosa, destruction of parietal and zymogenic cells with autoantibodies reactive to the gastric parietal cells and the gastric H+/K+ ATPase (ATP4), arguably hallmarks of a human autoimmune gastritis (AIG). In the case of AIG, it is well documented that, in addition to parietal cell antibodies being detected in up to 90% of patients, up to 70% have intrinsic factor antibodies with the later antibodies considered highly specific to patients with pernicious anemia. This is the first report specifically investigating the occurrence of intrinsic factor antibodies, cobalamin deficiency and pernicious anemia in EAG models. We conclude, in contrast to AIG, that, in the three EAG models examined, intrinsic factor is not selected as a critical autoantigen.

Topics: Anemia, Pernicious; Animals; Autoantibodies; Autoantigens; Autoimmune Diseases; Disease Models, Animal; Enzyme-Linked Immunosorbent Assay; Female; Gastritis; H(+)-K(+)-Exchanging ATPase; Immunoblotting; Intrinsic Factor; Male; Mice; Mice, Inbred BALB C; Mice, Transgenic; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Autoanalysis; Autoantibodies; Autoimmune Diseases; Female; Humans; Immunoassay; Intrinsic Factor; Luminescent Measurements; Male; Reference Values; Serum; Vitamin B 12; Vitamin B 12 Deficiency

The catalytic alpha and glycoprotein beta subunits of the gastric H/K ATPase are major molecular targets in human and mouse autoimmune gastritis. We have previously shown that the H/K ATPase beta subunit is required for the initiation of mouse gastritis and identified a gastritogenic H/K ATPase beta subunit peptide (H/Kbeta253-277). Here we report the generation of MHC class II-restricted TCR transgenic mice using V(alpha)9 and V(beta)8.3 TCR chains with specificity for the gastritogenic H/Kbeta253-277 peptide. We found an 8-fold reduction in CD4(+) T cells in the thymus of the transgenic mice. Despite the reduction in intrathymic CD4(+) T cells, V(beta)8. 3-expressing T cells comprised the majority (>90%) of peripheral spleen and lymph node T cells. These peripheral T cells retained their capacity to proliferate in vitro to the H/Kbeta253-277 peptide. Using the responsive T cells, we have restricted the gastritogenic T cell epitope to H/Kbeta261-274. Despite the capacity of the peripheral T cells to proliferate in vitro to the peptide, the majority ( approximately 80%, 13 of 16) of transgenic mice remained free of gastritis while a minority (20%, three of 16) spontaneously developed an invasive and destructive gastritis. Our results confirm that H/Kbeta261-274 is a gastritogenic peptide. The data also suggest that CD4 T cell tolerance to the gastritogenic peptide in the transgenic mice is maintained by a combination of intrathymic and peripheral tolerance mechanisms.

Topics: Animals; Autoantibodies; Autoimmune Diseases; Autoimmunity; CD4-Positive T-Lymphocytes; Gastric Mucosa; Gastritis; H(+)-K(+)-Exchanging ATPase; Immune Tolerance; Intrinsic Factor; Lymph Nodes; Lymphocyte Activation; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Mice, Transgenic; Parietal Cells, Gastric; Peptide Fragments; Receptors, Antigen, T-Cell, alpha-beta; Spleen; Swine; Thymus Gland

This review describes the early chronological events in the pursuit of a treatment for pernicious anaemia, and the subsequent discovery of vitamin B12 and the intrinsic factor. It details Castle's experiments which established the theory of extrinsic and intrinsic factors as hemopoietic principles, and describes the studies on purification of the anti-pernicious anaemia principle from liver tissue that terminated in the crystallization of vitamin B12 and identification of its coenzyme forms. Biochemical purification and characterization of the intrinsic factor secreted by the gastric parietal cells, and two other vitamin B12 proteins, R-binder (transcobalamin I, haptocorrin), and transcobalamin II, are discussed in detail. The biochemical reactions in micro-organisms and humans in which vitamin B12 is involved are then briefly reviewed, and finally and briefly the immunological basis of pernicious anaemia is discussed.

Topics: Anemia, Pernicious; Animals; Autoimmune Diseases; Gastric Mucosa; History, 19th Century; History, 20th Century; Humans; Intrinsic Factor; Liver; Transcobalamins; Vitamin B 12

Topics: ABO Blood-Group System; Administration, Oral; Aged; Anemia, Macrocytic; Anemia, Pernicious; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Diabetes Mellitus, Type 1; Female; Glutamate Decarboxylase; Humans; Hydroxocobalamin; Insulin; Intrinsic Factor; Iodide Peroxidase; Purpura, Thrombocytopenic, Idiopathic; Thyroglobulin

Although it is recognized that glossitis is a classical sign of pernicious anemia, occurring in the evolution of this disease, it is unfrequent for this sign to reveal this affection. We report two cases where diagnosis was evacuated on the presence of glossitis and macrocytosis despite absence of anemia. Confirmation was done by low serum cobalamin level, gastritis atrophy and presence of intrinsic factor antibody. We emphasize that increased clinical suspicion may lead to early diagnosis even if anemia is lacking.

Topics: Aged; Anemia, Pernicious; Autoimmune Diseases; Erythrocyte Indices; Female; Glossitis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12 Deficiency

Topics: Aged; Aged, 80 and over; Autoantibodies; Autoimmune Diseases; Female; HLA-DR3 Antigen; HLA-DR4 Antigen; Humans; Hypothyroidism; Intrinsic Factor; Parietal Cells, Gastric; Sjogren's Syndrome; Syndrome; Thyroiditis, Autoimmune; Vitamin B 12 Deficiency; Xerostomia

Pernicious anemia is an organ-specific autoimmune disease characterized by cobalamin deficiency, megaloblastic anemia, neuropathy, and autoimmune gastritis with anti-intrinsic factor autoantibodies. Type 1 anti-intrinsic factor autoantibodies block the cobalamin binding site of the intrinsic factor, a gastric protein required for the assimilation of cobalamin. The aim of our study was to identify the epitope domain of type 1 antibodies. Different series of peptides derived from the intrinsic factor sequence were synthesized and tested for antibody binding in enzyme-linked immunosorbent assay, radioisotope assay, gel filtration, and SDS-PAGE autoradiography. One of these peptides, named IF-R7 (the intrinsic factor aminoacid sequence 251-265), showed a type 1 antibody binding activity and inhibited, in vitro, their blocking activity with Ki at 2.3 microM. The cross-linking of IF-R7 to beta-lactoglobulin produced type 1 anti-intrinsic factor antibodies in immunized sheep. In vivo Schilling tests performed on guinea pigs also revealed IF-R7 peptide inhibition of type 1 antibody blocking activity. 256Ser, 258Lys, 262Tyr and 265Val of the IF-R7 were essential for the epitope recognition. Reactivity with type 1 antibodies was found in IF-R7 homologous peptides from herpesvirus Saimiri and from pathogenic Escherichia coli. In conclusion, the epitope of type 1 anti-intrinsic factor autoantibodies is located in the 251-265 amino acid sequence of the protein. The identification of this epitope will enable the definition of an experimental animal model of anti-IF autoimmunity in order to study the pathogenesis of pernicious anemia.

Topics: Amino Acid Sequence; Anemia, Pernicious; Animals; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Binding, Competitive; Epitopes; Guinea Pigs; Humans; Intrinsic Factor; Molecular Sequence Data; Oligopeptides; Peptide Fragments; Radioimmunoassay; Schilling Test; Sheep; Vitamin B 12

Ten cases of pernicious anaemia seen over a 15-year period (1973-1988) in a Lagos hospital are presented. Their ages ranged from 34 to 67 with a mean of 53.6 years. Females outnumbered males 6 to 4. Complications seen include gastric carcinoma, myelopathy, peripheral neuropathy, skin hyperpigmentation, hair depigmentation and diarrhoea. Reluctance to consider the diagnosis owing to firmly held notions of its rarity and a penchant for empirically treating chronic anaemias with all available haematinics and blood transfusion are probably contributory to its underdiagnosis. The fact that seven of the patients presented were seen in the last three years and three of them in the last one year raises the possibility of an increasing incidence of pernicious anaemia in Africans. The disease may be much less rare in Africans than once believed, and medical education should emphasize its existence and advocate greater care in the management of chronic anaemias.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Bone Marrow; Diagnosis, Differential; Fatigue; Female; Humans; Hydroxocobalamin; Incidence; Intrinsic Factor; Male; Middle Aged; Nigeria; Peripheral Nervous System Diseases; Pigmentation Disorders; Psychophysiologic Disorders; Retrospective Studies; Vitamin B 12; Vitamin B 12 Deficiency

Experimental autoimmune gastritis (AIG), defined by the appearance of auto antibodies to parietal cells, was induced by neonatal thymectomy in BALB/c nu/+mice 3 days after birth. Vitamin B12 absorption and intrinsic factor in the stomach extract decreased compared with those in AIG-negative control groups. No decrease of the serum A/G ratio in AIG-bearing mice was observed. Although development of anemia, as evaluated by a decrease in hematocrit value, was poor until 12 mo of age and the gastric mucosa was hypertrophic, the AIG resembled human pernicious anemia rather than Ménétrier's disease. Adoptive transfer of spleen cells, but not sera, of AIG-bearing nu/+ into BALB/c nu/nu mice caused AIG in all animals 1 mo later, indicating the involvement of lymphocytes in the induction mechanism of AIG. Cytofluorometric and immunohistochemical analysis of lymphocytes in the gastric mucosa revealed T-cell infiltration at an early stage (1.5-3 mo) followed by B cell infiltration (6 mo). When the fraction enriched with parietal cells, which were intensively stained with sera of AIG-bearing mice and fluorescent antibody to mouse immunoglobulin G, was injected into the foot pads of AIG-bearing nude mice, typical delayed-type hypersensitivity reaction was observed in all animals. This was not seen in the mice injected with the cell fraction enriched with chief cells, although a few of them were stained by the immunofluorescent technique. Thus, the delayed-type hypersensitivity reaction seems to be directly involved in the mechanism of tissue damage.

Topics: Anemia, Pernicious; Animals; Animals, Newborn; Antigen-Antibody Complex; Autoantibodies; Autoimmune Diseases; Disease Models, Animal; Female; Gastric Mucosa; Gastritis; Hypersensitivity, Delayed; Immunization, Passive; Intrinsic Factor; Lymphocytes; Male; Mice; Mice, Inbred BALB C; Mice, Nude; Parietal Cells, Gastric; Thymectomy; Vitamin B 12

Topics: Adult; Aged; Aged, 80 and over; Anemia, Pernicious; Autoimmune Diseases; Female; Humans; Intrinsic Factor; Male; Middle Aged; Spain; Stomach Diseases; Vitamin B 12 Deficiency

Topics: Anemia, Pernicious; Autoimmune Diseases; Child; Colitis, Ulcerative; Crohn Disease; Dermatomyositis; Digestive System Diseases; Hepatitis; Humans; Intrinsic Factor; Lupus Erythematosus, Systemic; Scleroderma, Systemic

A specific gastritis was induced in BALC/c (+/?) mice by thymectomy within 3 days after birth (25 to 45 per cent) or in BALB/c (nu/nu) mice by the injection of spleen cells (10(7)) from neonatally thymectomized mice (70 per cent). Normal peripheral lymphoid cells, irrespective of the sex and dose, were generally ineffective in inducing gastritis in nude mice, while thymus cells were partially effective (30 per cent). The induced gastritis was characterized by a loss of chief and parietal cells and by varying degrees of lymphoid cell infiltration along thickened muscularis mucosa. The fundic mucosa was replaced by mucous necklike immature cells, and there was a rise of pH of the gastric juice. Argyrophilic endocrine cells escaped the inflammation and increased in number. The gastritis induced in nude mice was generally more severe and was often followed by severe macrocytic anemia. Megaloblast-like large immature erythroid cells were numerous in the spleens of affected mice. Antiparietal cell antibodies (IgG) were always demonstrated by an indirect immunofluorescence test in the sera of gastritis-developing mice, but were absent in sera of normal or untreated conventional nude mice. These findings suggest a new animal model of pernicious anemia in man.

Topics: Anemia, Macrocytic; Animals; Animals, Newborn; Autoimmune Diseases; Disease Models, Animal; Female; Gastric Mucosa; Gastritis; Immunoglobulin G; Immunoglobulin M; Intrinsic Factor; Male; Mice; Mice, Nude; Spleen; Thymectomy

The diagnostic interest of a search for anti-intrinsic factor antibodies is emphasized from the authors research on more than 200 patients or controls. Antibodies of type I, so-called blocking antibodies, were detected in 66% of cases where the diagnosis of pernicious anemia was made. Type II, so-called precipitating antibodies, were found in 47% of patients with antibodies of type I and only in the latter. Certain etiological factors, already noted in the world literature, were found, in particular the link with the female sex and with blood group A. The specificity of these antibodies is very great and false positives are exceptional. We did not find them in any of the 104 controls. They were observed, however, in 5 of the 56 patients where the diagnosis of pernicious anemia was not definite, but it is likely that, in these 5 cases, pernicious anemia existed with some other disease. Our study also showed the limits of other methods of investigation of this disease; hypovitaminimia B12 is often corrected by treatment without proper inductions and B12 malabsorption on the Schilling test may not be corrected by the addition of intrinsic factor.

Topics: Anemia, Macrocytic; Anemia, Pernicious; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Blood Group Antigens; Diagnosis, Differential; False Positive Reactions; Female; Gastric Juice; Hematologic Diseases; Humans; Immunodiffusion; Intrinsic Factor; Male; Precipitins; Radioimmunoassay; Schilling Test; Sex Factors; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Antibodies; Antibody Formation; Autoimmune Diseases; B-Lymphocytes; Cell Migration Inhibition; Female; Fluorescent Antibody Technique; Gastric Juice; Gastritis; Humans; Immunity, Cellular; Intrinsic Factor; Lymphocyte Activation; Male; Swine; T-Lymphocytes

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Atrophy; Autoantibodies; Autoimmune Diseases; Female; Follow-Up Studies; Gastritis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Schilling Test; Time Factors; Vitamin B 12

Organ-specific antibodies were looked for in 26 patients with lichen sclerosus. Ten of the 25 female patients (40%) had organ-specific antibodies to thyroid cytoplasm and 11 (44%) had organ-specific antibodies to gastric parietal cells. Both values were significantly greater than those obtained in age-matched controls. None of the sera from patients with lichen sclerosus contained antibodies to steroid-producing tissues. No organ-specific antibodies were found in the one male patient.The findings suggest that lichen sclerosus may be related to an autoimmune process.

Topics: Adolescent; Adult; Aged; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Cytoplasm; England; Female; Gastric Mucosa; Humans; Intrinsic Factor; Lichens; Male; Middle Aged; Organ Specificity; Radioimmunoassay; Scotland; Skin Diseases; Thyroid Gland; Vitamin B 12; Vitiligo

Evidence of cell-mediated immunity to gastric intrinsic factor was present in 86% of patients with pernicious anaemia and in at least 13% of patients with hyperthyroidism, 21% of patients with atrophic gastritis, and four out of nine (46%) patients with hypogammaglobulinaemia. Controls gave negative results. The four patients with hypogammaglobulinaemia and cell-mediated immunity to intrinsic factor had evidence of impaired gastric function.

Topics: Agammaglobulinemia; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Cell Migration Inhibition; Diabetes Mellitus; Female; Gastritis; Hematocrit; Humans; Hyperthyroidism; Hypothyroidism; Immunity, Cellular; Intestinal Absorption; Intrinsic Factor; Leukocytes; Lymphocyte Activation; Male; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Antibody Formation; Antigen-Antibody Complex; Autoantibodies; Autoimmune Diseases; Chromatography, Gel; Cytotoxicity Tests, Immunologic; Gastritis; Humans; Immunity, Cellular; Immunologic Deficiency Syndromes; Intrinsic Factor; Lymphocytes; Mice; Stomach

Topics: Addison Disease; Adolescent; Adult; Antibodies, Anti-Idiotypic; Autoimmune Diseases; Candidiasis; Diabetes Mellitus; Female; Follicle Stimulating Hormone; Gastritis; Humans; Hypoparathyroidism; Hypopituitarism; Intrinsic Factor; Luteinizing Hormone; Myxedema; Ovarian Diseases; Syndrome; Thyroiditis, Autoimmune

Topics: Adult; Aged; Animals; Antibodies, Antinuclear; Autoantibodies; Autoimmune Diseases; Erythrocytes; Female; Fluorescent Antibody Technique; Humans; Immunity, Cellular; Intrinsic Factor; Latex Fixation Tests; Leukocytes; Lymphocytes; Mice; Middle Aged; Mitochondria; Muscle, Smooth; Rats; Schizophrenia; Sheep; Thyroid Gland

Topics: Adolescent; Adult; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Female; Fluorescent Antibody Technique; Humans; Hypothyroidism; Intrinsic Factor; Male; Pedigree; Stomach; Thyroid Gland

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Diabetes Mellitus; Diabetes Mellitus, Type 1; Female; Humans; Insulin Antibodies; Intrinsic Factor; Male; Middle Aged; Schilling Test

Topics: Adrenal Glands; Adrenal Insufficiency; Adult; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Endocrine System Diseases; Gastric Mucosa; Humans; Intrinsic Factor; Male; Thyroid Gland; Thyroiditis, Autoimmune; Vitiligo

Topics: Anemia, Pernicious; Animals; Antibody Formation; Autoantibodies; Autoimmune Diseases; Binding Sites; Haptens; Humans; Intrinsic Factor; Swine

Topics: Achlorhydria; Adolescent; Adult; Age Factors; Aged; Anemia, Pernicious; Antibodies; Autoantibodies; Autoimmune Diseases; Child, Preschool; Cobalt Isotopes; Female; Gastric Juice; Gastric Mucosa; Histamine; Humans; Hydrogen-Ion Concentration; Intrinsic Factor; Male; Middle Aged; Schilling Test; Sex Factors; Vitamin B 12; Vitiligo

Topics: Antigen-Antibody Reactions; Antigens; Autoantibodies; Autoimmune Diseases; Chronic Disease; Complement Fixation Tests; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor; Stomach

Topics: Adult; Autoimmune Diseases; Humans; Intrinsic Factor; Male; Myasthenia Gravis; Myxedema

The prevalence of circulating antibodies to gastric intrinsic factor and parietal cells was examined in 60 patients with histologically proven gastric carcinoma and was found not to differ from the prevalence of these antibodies in control subjects of similar age and sex distribution.Amongst the 60 patients with gastric carcinoma seven were thought to have actual or potential pernicious anaemia. The absence of an increased prevalence of antigastric antibodies in gastric carcinoma indicates that gastritis itself, whether autoimmune or not, is the likely common denominator underlying the predisposition to gastric carcinoma in both pernicious anaemia and chronic atrophic gastritis.

Topics: Adolescent; Adult; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Child; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Precancerous Conditions; Stomach; Stomach Neoplasms; Vitamin B 12

Topics: Adolescent; Adult; Age Factors; Aged; Anemia, Pernicious; Antibody Specificity; Autoantibodies; Autoimmune Diseases; Bone Marrow Examination; Child; Cobalt Isotopes; Cytoplasm; Diabetes Complications; Diabetes Mellitus; Diet Therapy; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Humans; Insulin; Intrinsic Factor; Male; Middle Aged; Organ Specificity; Radioimmunoassay; Schilling Test; Sex Factors; Staining and Labeling; Stomach; Thyroglobulin; Thyroid Gland; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Cell Movement; Female; Follow-Up Studies; Gastric Juice; Gastritis; Graves Disease; Humans; Hyperthyroidism; Intestinal Absorption; Intrinsic Factor; Leukocytes; Male; Middle Aged; Myxedema; Thyroid Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Antibody Specificity; Antigen-Antibody Reactions; Atrophy; Autoimmune Diseases; Biopsy; Chronic Disease; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Immune Tolerance; Intrinsic Factor; Stomach Ulcer

Topics: Anemia, Pernicious; Antibody Formation; Autoimmune Diseases; Complement Fixation Tests; Gastritis; Humans; Immunity, Cellular; Intestinal Mucosa; Intrinsic Factor

Topics: Anemia, Pernicious; Autoimmune Diseases; Gastric Juice; Humans; Immunoglobulin G; Intrinsic Factor; Stomach; Vitamin B 12

Topics: Aged; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Humans; Intrinsic Factor; Middle Aged; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Pernicious; Antibody Formation; Autoantibodies; Autoimmune Diseases; Cell Migration Inhibition; Gastric Juice; Humans; Intestinal Absorption; Intrinsic Factor; Nutritional Requirements; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Autoantibodies; Autoimmune Diseases; Chronic Disease; Female; Gastric Juice; Humans; Intestinal Absorption; Intrinsic Factor; Middle Aged; Purpura, Thrombocytopenic; Thyroid Gland; Vitamin B 12

Topics: Antibodies, Antinuclear; Autoantibodies; Autoimmune Diseases; Blood Sedimentation; Cobalt Isotopes; Complement Fixation Tests; Coombs Test; Fluorescent Antibody Technique; gamma-Globulins; Hemagglutination Tests; Humans; Immunodiffusion; Intrinsic Factor; Latex Fixation Tests; Neutrophils; Radioimmunoassay; Rheumatoid Factor; Thyroglobulin; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Antibody Formation; Antigen-Antibody Reactions; Autoantibodies; Autoimmune Diseases; Basement Membrane; Complement System Proteins; Erythrocytes; gamma-Globulins; Glomerulonephritis; Guinea Pigs; Humans; Hyperthyroidism; Intrinsic Factor; Iodine Isotopes; Long-Acting Thyroid Stimulator; Myasthenia Gravis; Organ Specificity; Thyrotropin; Vitamin B 12

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Pernicious; Antibodies; Arthritis, Rheumatoid; Atrophy; Autoimmune Diseases; Colitis, Ulcerative; Diarrhea; Female; Fluorescent Antibody Technique; gamma-Globulins; Gastric Mucosa; Gastritis; Giardiasis; Humans; Hypersensitivity; Hypersensitivity, Delayed; Infections; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Adult; Age Factors; Aged; Anemia, Pernicious; Antibodies, Antinuclear; Autoantibodies; Autoimmune Diseases; Female; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Sex Factors; Stomach; Thyroid Diseases; Thyroid Gland; Wales

Topics: Anemia, Pernicious; Animals; Antibody Formation; Autoantibodies; Autoimmune Diseases; Biological Transport; Gastric Juice; Humans; Immunodiffusion; Immunoglobulin G; Intrinsic Factor; Rabbits; Saliva; Stomach

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Diabetes Complications; Diabetes Mellitus; Female; Humans; Intrinsic Factor; Middle Aged; Thyroid Gland

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Capillary Resistance; Culture Media; Female; Humans; Hypersensitivity, Delayed; Intrinsic Factor; Leukocytes; Lymphocyte Activation; Male; Middle Aged

Topics: Addison Disease; Adrenal Glands; Adult; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Cytoplasm; Diabetes Complications; Diabetes Mellitus; Female; Humans; Hypothyroidism; Intrinsic Factor; Middle Aged; Stomach; Thyroid Gland

An immunoglobulin A of the secretory variety, present in the gastric juice of a patient with pernicious anemia, was shown to have specificity for intrinsic factor. This is the first demonstration in gastric juice of antibody activity restricted to secretory IgA; further, this is the first example of an exocrine (gastric) immune system producing an autoantibody specifically directed toward a product synthesized by that same exocrine organ.

Topics: Anemia, Pernicious; Animals; Autoantibodies; Autoimmune Diseases; Autoradiography; Cobalt Isotopes; Exocrine Glands; gamma-Globulins; Gastric Juice; Humans; Immunodiffusion; Intrinsic Factor; Rabbits

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Diabetes Complications; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Insulin; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Autoimmune Diseases; Colitis, Ulcerative; Complement Fixation Tests; Coombs Test; Digestive System; gamma-Globulins; Hepatitis; Humans; Intrinsic Factor; Liver Cirrhosis, Biliary; Liver Diseases; Neutrophils; Thyroid Diseases

Topics: Achlorhydria; Anemia, Pernicious; Autoimmune Diseases; Gastritis; History, 19th Century; History, 20th Century; Intrinsic Factor; Prednisolone; Thyroid Diseases; Thyroiditis, Autoimmune; Vitamin B 12

Topics: Age Factors; Aged; Antibodies; Arthritis, Rheumatoid; Autoimmune Diseases; Complement Fixation Tests; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Hematocrit; Hemoglobins; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hemolytic; Anemia, Pernicious; Autoimmune Diseases; Eye; Female; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Hair; Humans; Intrinsic Factor; Male; Middle Aged; Pedigree; Pigmentation; Vitamin B 12

Topics: Aged; Anemia, Pernicious; Autoimmune Diseases; Female; Gastric Acidity Determination; Gastric Mucosa; Humans; Intrinsic Factor; Male; Middle Aged; Prednisone; Vitamin B 12

Topics: Age Factors; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Bone Marrow; Diagnosis, Differential; Humans; Intrinsic Factor

Topics: Anemia, Pernicious; Antibodies; Autoantibodies; Autoimmune Diseases; Female; Gastric Juice; Gastritis; Humans; Intrinsic Factor; Male; Microscopy, Fluorescence; Prednisone; Saliva; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Antibodies; Autoantibodies; Autoimmune Diseases; Autoradiography; Cobalt Isotopes; Guinea Pigs; Humans; Immune Tolerance; Immunoelectrophoresis; Intestinal Absorption; Intrinsic Factor; Rabbits; Swine; Vitamin B 12

Topics: Adult; Aged; Antibodies; Autoimmune Diseases; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Humans; Intrinsic Factor; Male; Middle Aged; Schilling Test; Stomach

Topics: Anemia, Pernicious; Autoimmune Diseases; Humans; Immunoelectrophoresis; Intrinsic Factor

Topics: Allergy and Immunology; Anemia, Pernicious; Antibodies; Autoimmune Diseases; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Hemagglutination; Humans; Intrinsic Factor; Thyroglobulin; Thyroid Gland; Tissue Extracts

Topics: Agammaglobulinemia; Anemia, Hemolytic, Autoimmune; Animals; Arthritis, Rheumatoid; Autoantibodies; Autoimmune Diseases; Coombs Test; gamma-Globulins; Glomerulonephritis; Graft vs Host Disease; Humans; Intrinsic Factor; Rheumatoid Factor; Thyroglobulin; Thyroiditis, Autoimmune; Uveitis

Topics: Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Fluorescent Antibody Technique; Gastric Mucosa; Humans; Intrinsic Factor; Organ Specificity; Thyroiditis, Autoimmune

Topics: Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Complement Fixation Tests; Electrophoresis; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor