intrinsic-factor and Chronic-Disease

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

Patients of chronic gastritis should be investigated with gastric mucosal biopsy, parietal cell antibody, intrinsic factor antibody, Helicobacter pylori antibody, urea breath test or faecal antigen test for Helicobacter pylori, to accurately classify them. The results of these tests will indicate Helicobacter pylori infection (present or past), the role of hereditary factor (intrinsic factor antibody present or absent) and the success or failure of Helicobacter pylori eradication treatment.

Topics: Biopsy; Chronic Disease; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Intrinsic Factor; Parietal Cells, Gastric

Topics: Animals; Calcium; Chronic Disease; Humans; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Pancreatectomy; Pancreatic Diseases; Pancreatic Juice; Vitamin B 12; Vitamin B 12 Deficiency

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: Animals; Chronic Disease; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Intestinal Secretions; Intestine, Small; Intrinsic Factor; Pancreas; Pancreatic Diseases; Pancreatic Juice; Rats; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Chronic Disease; Diagnosis, Differential; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intrinsic Factor; Schilling Test

Topics: Adrenal Cortex Hormones; Anemia, Pernicious; Animals; Antibodies; Autoantibodies; Biopsy; Chronic Disease; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intrinsic Factor; Schilling Test; Stomach; Stomach Neoplasms; Stomach Ulcer; 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, Macrocytic; Anemia, Pernicious; Antigens; Autoantibodies; Biopsy; Chronic Disease; Cytoplasm; Digestive System; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immunologic Deficiency Syndromes; Intrinsic Factor; Lipoproteins; Microsomes; Schilling Test; Stomach; Vitamin B 12

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Aged; Anemia, Pernicious; Blind Loop Syndrome; Chronic Disease; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Stomach

Topics: Antibodies; Autoradiography; Chronic Disease; Depression, Chemical; Duodenal Ulcer; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methods; Protein Binding; Radioisotopes; Stimulation, Chemical; Stomach Neoplasms; Vitamin B 12

Topics: Acute Disease; Anemia, Pernicious; Chronic Disease; Gastric Juice; Gastritis; Humans; Intrinsic Factor; Stomach Neoplasms

Topics: Adolescent; Anemia, Pernicious; Autoantibodies; Child; Chronic Disease; Female; Gastric Mucosa; Humans; Hydrogen-Ion Concentration; Ileum; Infant; Intestinal Mucosa; Intrinsic Factor; Malabsorption Syndromes; Male; Pancreatic Diseases; Pregnancy; Vitamin B 12 Deficiency

To assess the prevalence and clinico-biologic characteristics of pernicious anaemia (PA) showing subtle or atypical onset.. One-hundred and twenty-four patients were found to fulfill criteria for PA (serum vitamin B12 deficiency due to absence of intrinsic factor secretion because of severe gastric atrophy). Of them were disclosed those lacking macrocytosis (MCV less than 98 fL), with or without anaemia (Hb less than 120 g/L in women and less than 14 f/L in men), but showing decreased serum B12 rates (less than 150 pmol/L).. Macrocytosis was absent in 15 out of the 124 cases (12.1%); either they had anaemia or not, serum B12 rates were decreased in all cases. Eight patients had concurrent iron deficiency, one had secondary anaemia, two had polycythaemia and four were normal from a haematological standpoint. Serum B12 assays were performed because of neuropsychiatric impairment (2 cases), polycythaemia study (3 cases), or positive anti-parietal cell antibodies found in an immunologic study (4 cases). The remaining patients were studied for chronic atrophy of the gastric mucosa (2 cases), and Plummer-Vinson syndrome, leucopenia and nutritional assessment (1 case of each condition).. Atypical presentation of pernicious anaemia, whose frequency is probably underestimated, was confirmed in our environment. This condition must be suspected and ruled out in patients with characteristics similar to those described above.

Topics: Anemia, Hypochromic; Anemia, Pernicious; Chronic Disease; Diagnosis, Differential; Gastritis, Atrophic; Humans; Intrinsic Factor; Iron Deficiencies; Polycythemia; Prevalence; Retrospective Studies; Vitamin B 12 Deficiency

The usefulness of the pancreatic dual-label Schilling test as an indirect test of pancreatic exocrine function was evaluated. This dual-label Schilling test was based on the difference of absorption for [58Co]cobalamin bound to hog R protein and [57Co]cobalamin bound to intrinsic factor. In this study, the test was performed in 7 normal subjects, 5 patients with pancreatectomy, 12 patients with chronic pancreatitis, 10 patients with suspicion of chronic pancreatitis, and 13 patients without chronic pancreatitis. The normal lower limit (mean -2 SD) of excretion ratio for [58Co]/[57Co] in 24-h urine was 0.68. Of the 26 patients on whom endoscopic retrograde pancreatography was performed, none of the 9 patients with normal pancreatogram, 4 of the 9 patients with mild to moderate pancreatitic changes in pancreatogram, and 7 of the 8 patients with advanced pancreatitic changes in pancreatogram showed a positive value lower than the ratio of 0.68 in this test. In 28 patients examined with the direct test of pancreatic secretory capacity, 2 of the 13 patients with normal function, 6 of the 9 patients with mild dysfunction, and 5 of the 6 patients with definite dysfunction were positive in this test. The results of the pancreatic dual-label Schilling test significantly correlated with those of a direct test of pancreatic secretory capacity and the findings of pancreatitic changes in pancreatogram (p less than 0.01, chi 2 test). The ratio for [58Co]/[57Co] correlated (r = 0.73) with the maximal bicarbonate concentration in duodenal juice of the direct test of pancreatic secretory capacity. The impairment of bicarbonate output by the pancreas may adversely affect the transfer of cobalamin from R protein to intrinsic factor. It suggested that the pancreatic dual-label Schilling test is useful for detecting not only patients with severe pancreatic insufficiency but also the relatively early stage of chronic pancreatitis with bicarbonate secretory dysfunction of the pancreas.

Topics: 4-Aminobenzoic Acid; Adult; Animals; Bicarbonates; Cholangiopancreatography, Endoscopic Retrograde; Chronic Disease; Cobalt Radioisotopes; Female; Humans; Hydrogen-Ion Concentration; In Vitro Techniques; Intrinsic Factor; Male; Middle Aged; Nuclear Proteins; Pancreas; Pancreatectomy; Pancreatic Function Tests; Pancreatitis; para-Aminobenzoates; Schilling Test; Swine; Vitamin B 12

The intraluminal transport of cobalamin (Cbl) remains controversial in chronic pancreatitis. We have determined the ability of intestinal juice to degrade the digestive holohaptocorrin (R binder) and the binding of endogenous Cbl in basal intestinal juice from 22 chronic pancreatitis patients and 22 controls. The intestinal juice from patients and controls degraded 34.7 +/- 32.3% and 95.2 +/- 7.2% of holohaptocorrin, respectively. This percentage was correlated with the trypsin output but not with the Schilling test. The unsaturated Cbl-binding capacity was similar in both groups. Respectively, 62.5 +/- 26.6% and 19.6 +/- 11.7% of endogenous Cbl was bound to haptocorrin in intestinal juice from patients and controls. These percentages were correlated with the Schilling test and with the ability of intestinal juice to degrade haptocorrin. We concluded that 1) the sequestration of Cbl to haptocorrin is one of the factors responsible for the malabsorption of crystalline Cbl in patients with chronic pancreatitis and 2) enterohepatic circulation of Cbl can be interrupted in some cases of chronic pancreatitis.

Topics: Adult; Aged; Chronic Disease; Chymotrypsin; Corrinoids; Humans; Intestinal Secretions; Intrinsic Factor; Malabsorption Syndromes; Middle Aged; Pancreatitis; Schilling Test; Trypsin; Vitamin B 12

The Authors show and discuss the classification proposed till now for dividing chronic atrophic gastritis into subtypes different in hystological, functional or immunological aspects. In accordance with the more recent reports, the classification into type A, type B and type AB is accepted. Genetical (factor A) and environmental agents (alcohol, smoke, drugs) as well as immunological (parietal and gastrin cell antibodies) and functional abnormalities (duodenogastric reflux), suggested to play a role in the aetiopathogenesis of chronic atrophic gastritis, are also re-examined. Finally, dynamic aspects of chronic atrophic gastritis and its association with anemia and gastric carcinoma are widely reviewed.

Topics: Age Factors; Antibodies; Chronic Disease; Gastritis; Gastritis, Atrophic; Gastroesophageal Reflux; Humans; Intrinsic Factor; Precancerous Conditions; Sex Factors; Smoking; Stomach Neoplasms; Substance-Related Disorders

To make a food preparation containing radioactively labelled cobalamins, rabbits were given repeated injections with 57Co-labelled cyanocobalamin. The liver was removed, homogenized, and fried for 1 min or boiled for 30 min. Of the radioactivity in the fried homogenate 41.7% was recovered in the centrifuged supernatant compared with 50.8% in the boiled homogenate. The radioactivity in the supernatants had a molecular size close to that of free 57Co-labelled cyanocobalamin. Forty-two per cent of the radioactivity in the whole homogenate had been incorporated into 5-deoxyadenosyl-, 10% into methyl-, and 16.5% into hydroxy-cobalamin. To assess the validity of a double-isotope method for measuring the intestinal absorption of doses of the 57Co-labelled liver cobalamins, 51CrCl3 was used as a non-absorbable marker. In 14 healthy volunteers the correlation coefficient between the absorption measured by the double-isotope technique and the faecal excretion test was highly significant (r = 0.96, p less than 0.005), and there was only a small variation in the 57Co/51Cr ratio in successive stool collections. In 11 patients with chronic diarrhoea there was a significant correlation between the absorption measured by the double-isotope technique and the faecal excretion test (r = 0.92, p less than 0.005), but in some patients there was considerable variation in the 57Co/51Cr ratio in successive stool collections.

Topics: Adult; Aged; Animals; Chromatography, Gel; Chronic Disease; Cobalt Radioisotopes; Diagnosis, Differential; Diarrhea; Food; Humans; Intestinal Absorption; Intrinsic Factor; Liver; Middle Aged; Molecular Weight; Rabbits; Transcobalamins; Vitamin B 12

Topics: Anemia, Pernicious; Chronic Disease; Female; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Genetic Markers; Humans; Intrinsic Factor; Male; Pedigree; Stomach Neoplasms

Topics: Achlorhydria; Aged; Anemia, Pernicious; Atrophy; Chronic Disease; Female; Gastritis; Humans; Intestine, Small; Intrinsic Factor; Malabsorption Syndromes; Pepsin A

The mean absorption of vitamin B12 (Schilling test) was 13.1 +/- 1.0 (% +/- S.E.M.) in 21 patients with chronic pancreatic insufficiency and 17.6 +/- 1.4 in 13 control patients (p less than 0.01). There was no correlation between pancreatic bicarbonate production after secretion stimulation and vitamin B12 absorption in the patient group (r = 0.117). Human duodenal juice reduced the uptake of 57CoB12-rat intrinsic factor (IF) by perfused rat small intestinal segments in vivo (p less than 0.01) as well as the uptake of 57CoB12-human IF by purified guinea-pig intestinal brush borders in vitro (p less than 0.01). The results confirm reduced absorption of vitamin B12 in chronic pancreatic insufficiency, but the mechanism remains uncertain.

Topics: Adolescent; Adult; Aged; Animals; Bicarbonates; Chronic Disease; Duodenum; Female; Guinea Pigs; Hot Temperature; Humans; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Male; Middle Aged; Pancreatic Diseases; Pancreatic Juice; Rats; Schilling Test; Vitamin B 12

A method is described for the isolation of parietal cells from the gastric mucosa of the guinea pig by enzymatic digestion with collagenase. A suspension was obtained that contained 70-80% parietal cells. About 80% of the cells were viable immediately after incubation, but viability dropped sharply after one hour. Parietal cells were identified by their morphology on light and electron microscopy, by their uptake of neutral red, by immunofluorescent staining and by carbonic anhydrase activity. Antibodies to four distinct parietal-cell antigens were obtained from rabbits immunized with the isolated parietal cells or fractions thereof. These antibodies were directed against the microsomal fraction of the parietal-cell cytoplasm, the plasma and nuclear membranes, the soluble proteins, and Castle's intrinsic factor. The antibody against the microsomal fraction, though reacting in the same way as the antibody to parietal cell canaliculi found in the serum of patients with pernicious anaemia, showed greater species specificity.

Topics: Anemia, Pernicious; Animals; Antibodies; Antigen-Antibody Reactions; Antigens; Anura; Cell Membrane; Cell Separation; Cell Survival; Chronic Disease; Cytotoxicity Tests, Immunologic; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Guinea Pigs; Humans; Immunization; Intrinsic Factor; Mice; Microscopy, Electron; Microsomes; Rabbits; Rana catesbeiana; Rats; Staining and Labeling; Time Factors

Topics: Adult; Alcoholism; Biological Transport, Active; Chronic Disease; Cobalt Radioisotopes; Diet Therapy; Dose-Response Relationship, Drug; Ethanol; Humans; Intestinal Absorption; Intestine, Small; Intrinsic Factor; Lipid Metabolism; Malabsorption Syndromes; Male; Middle Aged; Nutrition Disorders; Pancreatin; Vitamin B 12; Vitamins; Xylose

The role of autoimmune processes in the pathogenesis of atrophic gastritis, be it with or without pernicious anemia, is described on the basis of literature data. Various findings in cases of atrophic gastritis favor such a role, e.g. histological findings, the high incidence of autoantibodies against gastric mucosa, a high specificity of gastric antigens in cellular immune reactions, the concomitant occurrence of other auto-immune diseases, the favorable effect of immunosuppressive therapy. On an experimental basis transfer of autoimmune gastritis by lymphocytes from the ductus thoracicus lymph of sick animals to non-immunized animals does support this hypothesis.

Topics: Anemia, Pernicious; Animals; Autoantibodies; Chronic Disease; Dogs; Gastric Mucosa; Gastritis; Humans; Immunization, Passive; Immunosuppression Therapy; Intrinsic Factor; Lymphocytes

Topics: Administration, Oral; Adult; Anemia; Chronic Disease; Female; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Pancreatitis; Schilling Test; Trypsin; Vitamin B 12

Topics: Adolescent; Adult; Agammaglobulinemia; Anemia, Macrocytic; Anemia, Megaloblastic; Antibody Formation; Chronic Disease; Female; Gastric Juice; Humans; Immunoglobulin A; Immunoglobulin G; Immunologic Deficiency Syndromes; Intrinsic Factor; Malabsorption Syndromes; Male; Proteinuria; Syndrome; Vitamin B 12 Deficiency

Topics: Adolescent; Anemia, Macrocytic; Anemia, Pernicious; Chronic Disease; Consanguinity; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Recurrence; Vitamin B 12 Deficiency

Topics: Acute Disease; Age Factors; Animals; Antibodies; Chronic Disease; Gastric Mucosa; Gastritis; Gastroscopy; Humans; Immune System Diseases; Immunity, Cellular; Intrinsic Factor

Topics: Anemia, Pernicious; Antigen-Antibody Reactions; Autoantibodies; Chronic Disease; Gastric Mucosa; Gastritis; Humans; Immunity, Cellular; Immunoglobulins; Immunologic Deficiency Syndromes; Intrinsic Factor

Topics: Adult; Aged; Chronic Disease; Electrophoresis, Starch Gel; Endopeptidases; Enzyme Precursors; Gastric Acidity Determination; Gastric Juice; Gastritis; Histamine; Humans; Intestinal Diseases; Intrinsic Factor; Metaplasia; Middle Aged; Peptide Hydrolases; Spectrophotometry

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

Topics: Administration, Oral; Antibodies; Bacteria; Calcium; Chronic Disease; Cobalt Isotopes; Feces; Hemoglobins; Humans; Hydrogen-Ion Concentration; Ileum; Intestinal Absorption; Intestinal Secretions; Intrinsic Factor; Jejunum; Lipid Metabolism; Lipids; Malabsorption Syndromes; Pancreas; Pancreatic Diseases; Pancreatic Extracts; 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: Achlorhydria; Adolescent; Adult; Aged; Anemia, Pernicious; Biopsy; Chronic Disease; Female; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Stomach

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

Topics: Aged; Autoantibodies; Biopsy; Chronic Disease; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Thyroid Gland

Topics: Anemia, Pernicious; Atrophy; Autoantibodies; Chronic Disease; Fluorescent Antibody Technique; Gastritis; Humans; Intrinsic Factor

Topics: Adult; Aged; Atropa belladonna; Chronic Disease; Delayed-Action Preparations; Duodenal Ulcer; Gastric Acidity Determination; Gastric Juice; Histamine; Humans; Intrinsic Factor; Male; Middle Aged; Pepsin A; Phytotherapy; Plants, Medicinal; Plants, Toxic; Secretory Rate; Vagotomy