intrinsic-factor and Lupus-Erythematosus--Systemic

R4A is an anti-DNA antibody derived by hybridoma technology from a BALB/c mouse. The study of its properties has helped to elucidate aspects of the physiopathology of Systemic Lupus Erythematosus (SLE). It has been useful to decipher the mechanisms implicated in breaks in B cell self tolerance by B cell extrinsic or B cell intrinsic factors. Furthermore, it illustrates the importance of molecular mimicry in understanding the cellular and molecular effects relevant to some manifestations of neuropsychiatric lupus, as it cross-reacts with the D/E W D/E YS/G peptide sequence present in subunits of the N-methyl d-aspartate receptor (NMDAR).

Topics: Animals; Antibodies, Antinuclear; B-Lymphocytes; Blood-Brain Barrier; Brain; Female; Fetal Development; Humans; Intrinsic Factor; Lupus Erythematosus, Systemic; Male; Mice; Molecular Mimicry; Pregnancy; Prenatal Exposure Delayed Effects; Receptors, N-Methyl-D-Aspartate; Self Tolerance

As the co-existence of pernicious anaemia (PA) and systemic lupus erythematosus (SLE) has been repeatedly reported, we have investigated the presence of anti-intrinsic factor antibodies (IFAb), the immunological hallmark of PA, in patients diagnosed with SLE. Serum cobalamin levels and IFAb were determined in 30 women diagnosed with SLE as well as in 45 controls. Cobalamin levels were low in 7/30 patients. IFAb were detected in 3/30 sera from patients but in none of the control sera. The presence of IFAb was associated with a low cobalamin concentration, anaemia and macrocytosis in only one patient. There was no evident relationship between the presence of IFAb and serological markers of SLE. We conclude that IFAb may appear in SLE patients, although the cobalamin deficiency described in SLE seems to be due to the presence of IFAb in only a minority of cases.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies; Female; Fluorescent Antibody Technique; Hemoglobins; Humans; Immunodiffusion; Intrinsic Factor; Lupus Erythematosus, Systemic; Middle Aged; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

We describe an 82-year-old woman with systemic lupus erythematosus who developed pernicious anemia 3 years later. Although both diseases are autoimmune in origin, this association is rather rare, and only 3 other cases have been described. Pernicious anemia appeared after steroid treatment was withdrawn.

Topics: Aged; Aged, 80 and over; Anemia, Pernicious; Antibodies; Female; Humans; Intrinsic Factor; Lupus Erythematosus, Systemic

We describe a young black female with systemic lupus erythematosus who developed pernicious anemia. She had a positive Schilling test which became normal after steroid therapy in spite of persistence of intrinsic factor antibody and depression of serum complement levels.

Topics: Adult; Anemia, Pernicious; Antibodies; Complement C3; Female; Hemoglobins; Humans; Intrinsic Factor; Lupus Erythematosus, Systemic; Prednisone; Schilling Test

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

Using flow microfluorimetry (FMF), 60 sera from patients with pernicious anaemia (PA) were examined for immunoreactivity with the surface membranes of viable canine parietal cells. FMF analyses showed that the percentage of parietal cells giving a surface staining reaction with a fluorescence intensity greater than 50 arbitrary units was 44.5 +/- 17.5% for sera from 60 patients with PA compared to 13.7 +/- 2.7% for sera from 14 patients with chronic active hepatitis, 10.7 +/- 6.7% for sera from 10 patients with systemic lupus erythematosus and 16.5 +/- 4.4% for sera from 50 healthy persons. Surface staining detected by FMF was restricted to parietal cells and abolished by absorption with parietal cell enriched preparations but not by absorption with dog or rat hepatocytes, dog or rat kidney cells, human fibroblasts, human AB red blood cells or dog gastric microsomes. The intensity of the parietal cell surface staining reactions correlated with the presence of antibody reactions with parietal cell surfaces previously demonstrated by immunofluorescence microscopy but did not correlate with the presence of microsomal or intrinsic factor autoantibodies. The results provide further support for the presence of a parietal cell surface reactive autoantibody distinct from the conventional parietal cell microsomal autoantibody.

Topics: Anemia, Pernicious; Animals; Autoantibodies; Cell Membrane; Dogs; Flow Cytometry; Hepatitis, Chronic; Humans; Intrinsic Factor; Lupus Erythematosus, Systemic; Microsomes; Parietal Cells, Gastric

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

Acute phase reactants are nonspecific indicators of tissue necrosis and/or inflammation but may be helpful in determining activity of disease. Rheumatoid factor is likewise rather nonspecific, but its presence is helpful in predicting the course, severity, and complications of rheumatoid arthritis. Numerous antinuclear antibodies have been identified in collagen vascular diseases; perhaps the most specific association is between anti-Sm antibody and systemic lupus erythematosus. Anti-smooth-muscle and antimitochondrial antibodies can aid in differential diagnosis of liver disease, while antithyroid antibodies can perform a similar function in diffuse goiter. Anti-parietal-cell and anti-intrinsic-factor antibodies are quite specific for pernicious anemia.

Topics: Acute Disease; Adolescent; Adult; Aged; Antibodies; Antibodies, Antinuclear; Arthritis, Rheumatoid; Autoantibodies; Blood Sedimentation; C-Reactive Protein; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Immunologic Techniques; Infant; Infant, Newborn; Intrinsic Factor; Lupus Erythematosus, Systemic; Middle Aged; Pregnancy; Rheumatoid Factor

Topics: Anemia, Pernicious; Antibodies; Antigen-Antibody Reactions; Autoantibodies; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Hyperthyroidism; Hypothyroidism; Intrinsic Factor; Lupus Erythematosus, Systemic