vitamin-b-12 and Gastritis

Cerebral venous thrombosis (CVT) is a rare disease, occurring in 0.5%-1% of all patients with strokes. Systemic and hereditary diseases and traumas are potential causes of CVT. We report a case of CVT and systemic thromboembolism complicated with hyperhomocysteinemia and iron-deficiency anemia caused by autoimmune gastritis. A 47-year-old female patient was admitted to the emergency department due to difficulty in movement, impaired consciousness, and urinary incontinence. Brain computed tomography (CT) and magnetic resonance imaging (MRI) showed bilateral thalamic edema associated with venous sinus thrombosis and embolic cerebral infarction in the deep white matter of the bilateral cerebral hemispheres. In addition, contrast enhanced whole-trunk CT scan showed deep femoral thrombosis and pulmonary artery embolism. She had no medical history of diseases or drug use that may cause thrombosis. Blood test results revealed iron-deficiency anemia and hyperhomocysteinemia, which were determined to be the cause of systemic thromboembolism. The patient tested positive for intrinsic factor antibodies. Moreover, the patient was diagnosed with autoimmune gastritis by gastrointestinal endoscopy. Therapies including anticoagulant and replacement with iron and vitamin B12 were administered. The patient was discharged from the hospital without neurological deficits. A favorable clinical course was achieved with anticoagulant administration and replacement therapy with iron and vitamin B12 for cerebral arteriovenous embolism that developed due to autoimmune gastritis.

Topics: Anemia, Iron-Deficiency; Anticoagulants; Embolism; Female; Gastritis; Humans; Hyperhomocysteinemia; Intracranial Thrombosis; Iron; Middle Aged; Thromboembolism; Venous Thrombosis; Vitamin B 12

Pernicious anemia is still a neglected disorder in many medical contexts and is underdiagnosed in many patients. Pernicious anemia is linked to but different from autoimmune gastritis. Pernicious anemia occurs in a later stage of autoimmune atrophic gastritis when gastric intrinsic factor deficiency and consequent vitamin B

Topics: Anemia, Pernicious; Gastritis; Humans; Micronutrients; Precancerous Conditions; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency; Vitamins

This monograph on the clinical chemistry of vitamin B12 reviews the literature on daily requirements, methods for measurement, the effects of drugs on vitamin B12 metabolism absorption, pregnancy, clinical conditions associated with vitamin B12 deficiency, errors of metabolism, and reactions to vitamin therapy. Although only very small quantities of vitamin B12 are required to satisfy the daily requirement, a sufficient supply is stored in the liver to meet normal requirements for at least a 3-year period. A number of drugs are known to affect the absorption of vitamin B12, including neomycin, potassium chloride, p-aminosalicylic acid, and colchicine. Significantly reduced serum concentrations of vitamin B12 have been noted in users of oral contraceptives (OCs), although concentrations still remain within the limits of normal. It appears that the vitamin B12 level in OC users reestablishes itself at a different and somewhat lower level. Vitamin B12 binding protein appears to remain unchanged. A vitamin B12 deficiency is unusual in pregnant women who consume a normal, varied diet. On the other hand, lactating women whose diets are low in animal protein and dairy products may have problems providing enough vitamin B12 to meet their own and their infant's needs; supplementary oral vitamins should be considered.

Topics: Absorption; Adult; Alcoholism; Anemia, Pernicious; Ascorbic Acid; Autoantibodies; Biguanides; Biological Transport; Chemical Phenomena; Chemistry; Chlorpromazine; Contraceptives, Oral; Diet; Female; Gastrectomy; Gastritis; Humans; Intrinsic Factor; Malabsorption Syndromes; Male; Metabolism, Inborn Errors; Middle Aged; Neoplasms; Nervous System Diseases; Nitrous Oxide; Nutritional Requirements; Pancreatic Diseases; Parasitic Diseases; Pregnancy; Pregnancy Complications; Transcobalamins; Vitamin B 12; 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: Adolescent; Anemia; Animals; Biological Transport; Blind Loop Syndrome; Calcium; Gastric Mucosa; Gastritis; Guinea Pigs; Humans; Hydrogen-Ion Concentration; Ileum; Intestinal Absorption; Intestinal Diseases, Parasitic; Intestinal Mucosa; Intrinsic Factor; Male; Pancreatic Diseases; Radiation Effects; Rats; Thalassemia; Trypsin; Vitamin B 12; Vitamin B 12 Deficiency

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: ABO Blood-Group System; Celiac Disease; Chronic Disease; Colitis, Ulcerative; Crohn Disease; Drainage; Esophageal Diseases; Female; Folic Acid; Gastrectomy; Gastritis; Gastrointestinal Diseases; Gastrointestinal Hemorrhage; Heavy Chain Disease; Hepatitis, Viral, Human; Humans; Hypersplenism; Intestinal Diseases; Iron; Liver Diseases; Middle Aged; Pancreatic Diseases; Vagotomy; Vitamin B 12

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: Anemia, Hypochromic; Anemia, Pernicious; Animals; Burns, Chemical; Celiac Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; In Vitro Techniques; Intrinsic Factor; Peptic Ulcer; Stomach Neoplasms; Vitamin B 12; Vitamin B 12 Deficiency

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: Age Factors; Anemia, Pernicious; Antibodies; Atrophy; Bethanechol Compounds; Carbachol; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Histamine; Humans; Insulin; Intrinsic Factor; Methacholine Compounds; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Atrophy; Autoimmune Diseases; Female; Gastritis; Gastritis, Atrophic; Humans; Pregnancy; Vitamin B 12; Vitamin B 12 Deficiency

Type 1 diabetes mellitus (T1DM) is a lifelong diagnosis that involves immune-mediated damage of pancreatic beta cells and subsequent hyperglycemia, manifesting as: polyuria, polydipsia, polyphagia, and weight loss. Treatment of type 1 diabetes centers on insulin administration to replace or supplement the body's own insulin with the goal of achieving euglycemia and preventing or minimizing complications. Patients with T1DM are at risk for developing other autoimmune conditions, most commonly thyroid or celiac disease.. A 20-year-old African American female with T1DM was referred by her endocrinologist to pediatric gastroenterology for 2 months of nocturnal, non-bloody diarrhea, left lower quadrant pain, and nausea; she was also being followed by neurology for complaints of lower extremity paresthesias and pain. The patient's initial lab-workup was remarkable for a low total Immunoglobulin A (IgA) level of < 6.7 mg/dL. As IgA deficiency is associated with an increased risk of celiac disease, the patient underwent upper and lower endoscopy, which was grossly unremarkable; however, histology revealed a pattern consistent with autoimmune gastritis. Subsequent serum evaluation was remarkable for an elevated fasting gastrin level and an elevated parietal cell antibody level without macrocytic anemia, iron deficiency, or vitamin B12 depletion. The patient was diagnosed with autoimmune gastritis (AIG) and subsequently initiated on parenteral B12 supplementation therapy with improvement in her neurologic and gastrointestinal symptoms.. This case illustrates the importance of recognition of red flag findings in a patient with known autoimmune disease. Following well-established health maintenance recommendations for individuals with T1DM ensures that common comorbidities will be detected. Autoimmune gastritis, while a rarer pathology in the pediatric population, deserves consideration in patients with pre-existing autoimmune conditions and new gastrointestinal or neurologic symptoms, as AIG can be associated with poor outcomes and risk of malignancy. Initial lab findings associated with an eventual diagnosis of AIG typically include anemia, iron deficiency, or Vitamin B12 deficiency. However, as demonstrated in this case, symptoms of AIG can rarely present before anemia or Vitamin B12 deficiency develops. To prevent permanent neurological damage, parenteral Vitamin B12 therapy must be considered even in the absence of Vitamin B12 deficiency, especially in those patients already experiencing neurological symptoms.

Topics: Adult; Anemia, Iron-Deficiency; Autoimmune Diseases; Celiac Disease; Child; Diabetes Mellitus, Type 1; Diarrhea; Female; Gastritis; Humans; Insulins; Pain; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Nitrous oxide is among the most common drugs used by adolescents and young adults, and its neuropsychiatric sequelae are severe but reversible with timely treatment. The causal mechanism relates to impaired metabolism of vitamin B12, which is necessary for the development and maintenance of the myelin sheath. Individuals most susceptible to neuropsychiatric manifestations are those with a secondary cause of vitamin B12 deficiency, including nutritional deficiency and impaired absorption, or an alternative cause of impaired metaboclism. We describe the case of a man in his thirties who developed subacute combined degeneration of the spinal cord and polyneuropathy in the setting of recreational nitrous oxide use and autoimmune atrophic gastritis. Our case highlights clinical pearls for diagnosis and treatment, differential diagnosis, common concomitant aetiologies and the importance of screening for substance use disorder and psychiatric comorbidities.

Topics: Adolescent; Atrophy; Gastritis; Gastritis, Atrophic; Humans; Male; Nitrous Oxide; Spinal Cord; Subacute Combined Degeneration; Vitamin B 12; Vitamin B 12 Deficiency; Young Adult

Topics: Fatigue; Gastritis; Hand; Humans; Hyperpigmentation; Infusions, Parenteral; Male; Middle Aged; Tongue; Vitamin B 12; Vitamin B 12 Deficiency

Helicobacter pylori (H. pylori) infection is known as the most common cause of worldwide common chronic gastritis. Pathogenic mechanisms caused by H. pylori in diseases are still not fully understood. In addition, it has been reported that H. pylori can alter gene expressions in infected tissues and affect transcription factor activation. It is reported that aryl hydrocarbon receptor (AhR), which is a cytoplasmic transcription factor, functions in the immune system and plays a role in immune cells in barrier organs such as the gastrointestinal system, skin, and lungs. H. pylori infection affects the absorption of micronutrients such as trace elements, minerals, and vitamins by disrupting gastric secretion and acidification functions. Zinc (Zn) trace element is thought to be able to modulate the induction of AhR-responsive genes in endothelial cells. Although it is emphasized that trace elements are related with gastritis, relationship between Zn and AhR is not fully known, especially in chronic gastritis accompanied by H. pylori infection. In this study, serum levels of AhR, Zn, and AhR antagonist vitamin B12 were determined in chronic gastritis with H. pylori infection. Fifty volunteers diagnosed with H. pylori positive and negative chronic gastritis were included in this study. Collected from individuals participating were 5 ml of venous blood samples, and their serums were separated. AhR serum level of the study group was determined using enzyme-linked immunosorbent assay method. Zn concentrations in serum samples were measured using inductively coupled plasma atomic emission spectroscopy. When AhR and Zn serum levels were compared in H. pylori positive and negative chronic gastritis patients, it was found that AhR serum level of H. pylori positive chronic gastritis patients increased but it was not statistically significant (p = 0.595). However it was determined Zn and B12 serum levels were statistically significantly decreased (p < 0.001). This study has a crucial importance since to be the first one investigating relationship between serum AhR, Zn, and vitamin B12 levels in the pathogenesis of H. pylori gastritis in adults. Examination of AhR, Zn and B12 levels in H. pylori positive gastritis patients contributes to elucidating molecular mechanism of the disease.

Topics: Adult; Endothelial Cells; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Receptors, Aryl Hydrocarbon; Vitamin B 12; Zinc

OBJECTIVE To identify minimally invasive biomarkers to help differentiate dogs with gastric carcinoma from those with chronic gastritis. DESIGN Prospective study. ANIMALS 15 dogs with gastric carcinoma, 29 dogs with chronic gastritis, and 7 healthy dogs. PROCEDURES Dogs with clinical signs of upper gastrointestinal tract disease for > 14 days that underwent gastroscopy or necropsy for collection of gastric biopsy specimens for histologic evaluation were prospectively enrolled. Gastric carcinoma and chronic gastritis were diagnosed on the basis of histologic findings. Additionally, gastric biopsy specimens were collected endoscopically from 7 healthy (control) dogs while they were anesthetized for a routine neutering procedure. Prior to being anesthetized for gastroscopy or euthanized, all dogs underwent a physical examination, and a blood sample was collected for quantification of select serum biomarker concentrations. Histologic findings, body condition score (BCS), and serum biomarker concentrations were compared among the 3 groups. RESULTS Dogs with gastric carcinoma were significantly older and had a significantly lower BCS, lower serum folate concentration, and greater serum C-reactive protein (CRP) concentration, compared with dogs with chronic gastritis and control dogs. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that age > 8 years, BCS < 4, serum CRP concentration > 25 mg/L, and an abnormally low serum folate concentration might be useful noninvasive biomarkers for identification of dogs with gastric carcinoma. For underweight older dogs with signs of upper gastrointestinal tract disease and high serum CRP and low serum folate concentrations, gastric biopsy specimens should be obtained and evaluated so that a prompt definitive diagnosis can be made and appropriate treatment initiated.

Topics: Aging; Animals; Biomarkers; Blood Cell Count; Body Composition; Carcinoma; Cytokines; Dog Diseases; Dogs; Female; Folic Acid; Gastritis; Male; Stomach Neoplasms; Vitamin B 12

Helicobacter pylori (H. pylori) is closely associated with pre-neoplastic lesions such as atrophic gastritis (AG) and gastric intestinal metaplasia (GIM). The relationshionship between inflammation, hyperhomocysteinemia and arterial stiffness is of pathophysiological relevance for the development of cardiovascular disease. This study aimed to investigate the relationship between vitamin B12, folic acid, homocysteine (Hcy) and pulse wave velocity (PWV) levels in patients with GIM, AG and non-atrophic non-metaplastic chronic gastritis.. ninety-seven patients with GIM, 67 patients with AG and 69 patients with chronic gastritis were included in the study. Glucose, creatinine, total cholesterol, triglyceride, low-density lipoprotein, cholesterol, high-density lipoprotein cholesterol, vitamin B12, folic acid and Hcy levels were measured by biochemical methods. PWV and other vascular parameters were measured using the Phsyio-port AS device.. PWV was higher in patients with GIM and AG than in controls (p < 0.05 and p < 0.05, respectively). Vitamin B12 levels were significantly lower in patients with GIM and AG than in controls (p < 0.01 and p < 0.01, respectively). Folic acid levels were significantly lower in patients with GIM than in controls (p < 0.05). Hcy levels were significantly higher in patients with GIM and AG than in controls (p < 0.001 and p < 0.05, respectively). A logistic regression analysis showed that GIM, AG and vitamin B12 deficiency were predictors for arterial stiffness.. PWV values increased in patients with GIM and AG compared to non-atrophic non-metaplastic chronic gastritis, without different conventional cardiovascular risk factors.

Topics: Adult; Aged; Chronic Disease; Female; Folic Acid; Gastritis; Gastritis, Atrophic; Homocysteine; Humans; Intestines; Male; Metaplasia; Middle Aged; Pulse Wave Analysis; Stomach; Vascular Stiffness; Vitamin B 12

Autoimmune gastritis patients may have autonomic nerve dysfunction. The goal of our study was to explore the predictive value of two scoring systems in the differentiation of altered autonomic nerve function in autoimmune gastritis patients.. Seventy-five patients with autoimmune gastritis were evaluated by using cardiovascular reflex tests in order to delineate autonomic nerve function. Data were analyzed by using two laboratory-based scoring systems: "global score" (hemoglobin, mean corpuscular volume, gastrin, vitamin B12, and chromogranin A) and "simple score" (hemoglobin, mean corpuscular volume, gastrin) in order to discriminate deranged and normal autonomic nerve function.. Mean "simple" and "global" scores were significantly higher in subjects with altered autonomic dysfunction than in subjects with normal autonomic function (3.55±1.88 vs. 0.908±0.409, p<0.001 and 5.95±2.07 vs 2.46±1.28, p<0.001, respectively). Receiver operatör characteristic (ROC) analysis revealed that the optimum "simple score" cutoff point was 0.75 with a sensitivity of 86.7% and specificity of 92.3% for discriminating autoimmune gastritis patients with autonomic nerve dysfunction from patients with normal autonomic nerve function [area under the curve (AUC): 88.3, positive predictive value (PPV): 97.5% and negative predictive value (NPV): 66.6%; 95% confidence interval (CI), 88.4-99.7].. Simple score and global score have a high predictive value in the assessment of autoimmune gastritis patients with autonomic nerve dysfunction. These scoring systems may help physicians while evaluating autoimmune gastritis patients for the existence of autonomic nerve dysfunction instead of complex cardiovascular reflex tests.

Topics: Area Under Curve; Autoimmune Diseases; Autonomic Nervous System; Autonomic Nervous System Diseases; Chromogranin A; Erythrocyte Indices; Gastrins; Gastritis; Hemoglobins; Humans; Predictive Value of Tests; ROC Curve; Sensitivity and Specificity; Severity of Illness Index; Vitamin B 12

Lymphocytic gastritis is an idiopathic disease, characterized by intraepithelial infiltration of large numbers of T lymphocytes and often described in association with coeliac disease and Helicobacter pylori infection. Although usually associated with iron deficiency anaemia, there is no description on the association between lymphocytic gastritis and secondary vitamin B

Topics: Aged; Anemia; Chronic Disease; Ferrous Compounds; Gastritis; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Male; Recurrence; T-Lymphocytes; Vitamin B 12; Vitamin B 12 Deficiency

Elderly patients with autoimmune gastritis might have different symptoms than those of young patients. The aim of the present study was to compare presented symptoms and laboratory parameters associated with autoimmune gastritis in both old and young age groups.. A total of 355 patients with autoimmune gastritis were stratified into two groups: 65 years or older (n = 119, mean age 69.47 ± 5.027 years), and under 65 years (n = 236, mean age 45.79 ± 10.51 years). These two groups were then evaluated and compared by means of clinical symptoms, concurrent autoimmune diseases, serum gastrin, vitamin B

Topics: Adult; Age Distribution; Aged; Analysis of Variance; Autoimmune Diseases; Cohort Studies; Female; Gastrins; Gastritis; Humans; Male; Middle Aged; Multivariate Analysis; Prevalence; Prognosis; Retrospective Studies; Risk Assessment; Severity of Illness Index; Statistics, Nonparametric; Vitamin B 12

Little information is available about long-term outcomes of major gastric surgery when performed very early in life and adverse consequences in growing children might be expected. In this case, gastrectomy with Roux-en-Y esophagojejunostomy was performed in early childhood. Despite stomach loss, growth velocity paralleled the third percentile for age during development. Maintained on a daily multivitamin and monthly B12 injections, no overt nutritional deficiencies were detected in adulthood. However, dual energy X-ray absorptiometry scan at age 31 revealed that the patient had abnormally low bone mineral density. This case study demonstrates that even after gastrectomy and reconstruction early in life, linear growth can be achieved. However, bone density can be adversely affected, even in the face of normal serum calcium and vitamin D levels.

Topics: Absorptiometry, Photon; Adult; Anastomosis, Roux-en-Y; Body Mass Index; Bone Density; Calcium; Dietary Supplements; Female; Follow-Up Studies; Gastrectomy; Gastritis; Humans; Infant, Newborn; Jejunum; Osteoporosis; Treatment Outcome; Vitamin B 12; Vitamin B Complex

Helicobacter pylori-associated corpus atrophy and autoimmune gastric atrophy share similar histopathologic and clinical aspects. In our study, the relation between Helicobacter pylori and autoimmune gastritis was investigated.. Eighty-two consecutive histologically and serologically Helicobacter pylori-positive and 96 Helicobacter pylori-negative patients were enrolled in the study. All patients underwent diagnostic upper esophagogastroduodenal endoscopy. Three biopsy specimens from the antrum and corpus greater curvature were obtained for histologic evaluation. Serum samples were collected for detection of anti-parietal cell antibody, anti-Helicobacter pylori IgG and vitamin B12. Statistical analyses were determined with Student t-test and chi-square test. Statistical significance was determined with a p-value <0.05.. Of 82 Helicobacter pylori-positive patients, 45 were female and 36 were male, with a mean age 45.1 ± 15.1. There was no significant difference in age, gender and corpus atrophy between the Helicobacter pylori-positive and -negative groups. Eleven Helicobacter pylori-positive patients (13.4%) and 14 (14.6%) Helicobacter pylori-negative patients were positive for anti-parietal cell antibody; the difference between the two groups was not statistically significant (p>0.05). Differences in esophagogastroduodenal endoscopy findings, antrum and corpus inflammation, antrum and corpus atrophy, and vitamin B12 levels were found to be insignificant between parietal cell antibody-positive and -negative groups (p>0.05).. We did not find any relation between Helicobacter pylori infection and anti-parietal cell antibody, a marker of autoimmune gastritis. Long-term follow-up of Helicobacter pylori-infected patients and also determination of the relation between eradication of Helicobacter pylori and autoimmune atrophic gastritis are needed.

Topics: Adult; Aged; Antibodies, Bacterial; Autoantibodies; Autoimmune Diseases; Case-Control Studies; Dihydrotachysterol; Female; Gastric Mucosa; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Immunoglobulin G; Male; Middle Aged; Parietal Cells, Gastric; Prevalence; Risk Factors; Seroepidemiologic Studies; Vitamin B 12

The aim of this retrospective study of patients with tongue pain who showed no improvement after initial treatment and examination was to find out if their lack of response correlated with serum concentrations of zinc, vitamin B12, folic acid, and copper, and if it was associated with coexisting systemic diseases. We studied 311 patients for whom we had data about serum concentrations of these elements, and recorded whether they had any systemic diseases and were taking medicines regularly. One patient (0.3%) had a copper concentration outside the reference range; 2 patients (0.6%) had folic acid concentrations outside the reference range. The corresponding number for vitamin B12 was 5 (2%), and for zinc 30 (10%). The systemic diseases with the highest rates were: hyperlipidaemia (n=53, 17%), gastritis or gastric ulcer (n=51, 16%), angina pectoris (n=39, 13%), diabetes mellitus (n=31, 10%), thyroid disease (n=31, 10%), mild mental disorder (n=27, 9%), hypertension (n=18, 6%), cerebral infarction (n=17, 6%), leiomyoma (n=15, 5%) and anaemia (n=15, 5%). Roughly 10% of the patients were deficient in zinc. This study suggested that the serum concentration of zinc was most important to the patients with tongue pain. Many patients had more than one systemic condition, and all were taking various drugs.

Topics: Adult; Aged; Aged, 80 and over; Anemia; Angina Pectoris; Cerebral Infarction; Copper; Diabetes Complications; Female; Folic Acid; Gastritis; Glossalgia; Humans; Hyperlipidemias; Hypertension; Leiomyoma; Male; Middle Aged; Retrospective Studies; Thyroid Diseases; Vitamin B 12; Young Adult; Zinc

Topics: Administration, Oral; Biopsy; Cross-Sectional Studies; Diagnosis, Differential; Gastric Mucosa; Gastritis; Gastroscopy; Humans; Injections, Intramuscular; Male; Middle Aged; Nutritional Requirements; Risk Factors; Vitamin B 12; Vitamin B 12 Deficiency

The most frequent organ-specific autoimmune diseases associated with type 1 diabetes mellitus in children are hypothyroidism and celiac disease. Among adults, other associations exist, notably with pernicious anemia, which is extremely rare in children. We relate the observation of an adolescent with type 1 diabetes mellitus and hypothyroidism, admitted for severe anemia in addition to chronic anemia caused by autoimmune gastritis. Blood cell count showed severe aregenerative anemia with pancytopenia, with signs of non-autoimmune hemolysis. Vitamin B12 levels were low, bone marrow aspiration revealed erythroid hyperplasia, and anti-intrinsic factor antibodies were positive, providing the diagnosis of pernicious anemia. Treatment with intramuscular vitamin B12 produced brisk reticulosis after 6 days, with a subsequent rapid resolution of the anemia. Follow-up of type 1 diabetes mellitus in children requires screening for organ-specific autoimmune diseases; in case of unexplained anemia, autoimmune gastritis must be suggested. It can evolve into pernicious anemia.

Topics: Adolescent; Anemia, Pernicious; Autoimmune Diseases; Diabetes Mellitus, Type 1; Female; Gastritis; Hemolysis; Humans; Pancytopenia; Vitamin B 12; Vitamins

A 90-year-old woman was referred and admitted to our hospital because of progressing dementia, decreased appetite, and general fatigue. Blood tests on admission disclosed: white cell count, 2,900 /mm(3); hemoglobin 5.6 g/dl; mean corpuscular volume; 139.7 microm(3). Based on the presence of pancytopenia, macrocytic anemia, and elevated lactate dehydrogenises, we suspected pernicious anemia. We administered vitamin B12, which improved the blood test results and the signs of dementia. Gastrointestinal tract examination showed type A gastritis. Tests for anti-intrinsic factor antibody and anti-gastric parietal cell antibody were positive, which help confirm a diagnosis of pernicious anemia. Pernicious anemia is an autoimmune disease common among those aged 50-60 years. Cases aged over 90 years are rare. However, the numbers of extremely elderly patients are expected to increase with the growth of the elderly population. Fortunately, pernicious anemia is easy to treat. We need to make an appropriate diagnosis of pernicious anemia in the oldest elderly patients.

Topics: Aged, 80 and over; Anemia, Pernicious; Dementia; Female; Gastritis; Heart Failure; Humans; Vitamin B 12

Helicobacter pylori is one of the most common causes of peptic ulcer disease worldwide and a major cause of chronic superficial gastritis leading to atrophy of gastric glands.. A total of 60 patients suffering from gastric disease due to H. pylori infection were evaluated. Endoscopy was performed and gastric biopsies were obtained for histopathology and urease test. Blood was simultaneously collected for the determination of the levels of vitamin B12 and the MCV. Vitamin B12 levels were determined by chemiluminescent assay.. Our results indicate that the mean vitamin B12 level +/- SEM for the total population, the H.pylori infected and non-infected patients were 264.5+/-22.9, 207.7+/-21.9 and 419.7+/-39.8 respectively. H. pylori was found in 71.7% (43/60) of the patients tested. The level of vitamin B12 was lower than 200pg/ml (deficient) in 67.4% (29/43) of patients tested positive for H. pylori.. H. pylori appears to be implicated in causing vitamin B12 deficiency.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cross-Sectional Studies; Endoscopy, Gastrointestinal; Erythrocyte Indices; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Middle Aged; Virulence; Vitamin B 12; 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: Aged; Aged, 80 and over; Diabetes Mellitus; Famotidine; Gastritis; Histamine H2 Antagonists; Humans; Hypoglycemic Agents; Metformin; Proton Pump Inhibitors; Vitamin B 12; Vitamin B 12 Deficiency

We investigated the biochemical markers of bone metabolism in children with Helicobacter pylori infection. Biochemical markers of bone metabolism and serum levels of vitamin B12, ferritin and estradiol were measured in 41 H. pylori-positive (+) children (23 girls, 18 boys; aged 11.8+/-3 years). Serum levels of intact parathyroid hormone, ss-collagen I carboxy terminal telopeptide, total alkaline phosphatase (ALP), bone-specific ALP, N-terminal cross-links of human procollagen type I, N-mid-osteocalcin, calcium, phosphate, ferritin, and estradiol did not differ significantly between H. pylori(+) and H. pylori negative (-) children. Vitamin B12 levels were significantly decreased in H. pylori(+) compared to H. pylori(-) children. H. pylori infection was not accompanied by significant changes in markers of bone metabolism in children, although vitamin B12 levels were decreased. Further studies are required to clarify whether H. pylori infection causes time-dependent changes in bone turnover markers during the long course of this inflammatory disease.

Topics: Adolescent; Biomarkers; Bone and Bones; Bone Remodeling; Child; Child, Preschool; Collagen Type I; Estradiol; Female; Ferritins; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Male; Parathyroid Hormone; Peptides; Vitamin B 12

Proper absorption of vitamin B12 requires gastric corpus mucosa that functions appropriately and secretes intrinsic factor needed as an essential cofactor for the absorption of dietary vitamin B12 in the small bowel. Here we describe the prevalence of vitamin B12 deficiency and atrophic corpus gastritis (ACG) in patients with coronary heart disease. Fasting serum was obtained from patients who were admitted for cardiovascular diseases at the Coronary Care Unit in Nijmegen, the Netherlands. The status of gastric mucosa was assessed by using the serum levels of pepsinogens I and II, gastrin-17, and Helicobacter pylori IgG antibodies and analyzed over vitamin B12 level subgroups. The study population consisted of 376 patients (mean age, 65 years [SD, 13 years], 227 [60%] males). Low vitamin B12 levels (<150 pM) were detected in 28 patients (7%). Of these 28 patients, 5 (18%) had ACG according to the biomarker assays. Altogether, another 140 patients (37%) had vitamin B12 levels between 150 and 250 pM, of whom 10 (7%) had ACG. Of the remaining patients, five (2%) had ACG. Deficiency of vitamin B12 is common among subjects with coronary heart disease. Up to 20% of these deficiencies are related to ACG.

Topics: Aged; Biomarkers; Coronary Disease; Enzyme-Linked Immunosorbent Assay; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Pepsinogens; Retrospective Studies; Vitamin B 12

A 25-year-old woman was admitted because of severe anemia and exercise-induced tachypnea and dyspnea. She had no gastrointestinal symptoms and reported no allergies. The family history did not reveal any obvious or familial disease.. Whole blood analysis showed severe macrocytic anemia. The vitamin B12 level was reduced and biopsies revealed autoimmune gastritis and typical megaloblastic changes in the bone marrow. Gastroscopy showed marked mucosal atrophy as seen in celiac disease. Vitamin B12 was administered parenterally and she was put on a gluten-free diet.. The combination of autoimmune gastritis and celiac sprue is most likely a variant of the polyglandular autoimmune syndrome type 2. Early diagnosis, life-long gluten-free diet and vitamin B12 administration as well as appropriate aftercare prevent serious complications.

Topics: Adult; Anemia, Macrocytic; Autoimmune Diseases; Bone Marrow; Celiac Disease; Female; Gastritis; Glutens; Humans; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

Iron deficiency is a known complication of achlorhydria and may precede the development of pernicious anemia. Among 160 patients with autoimmune gastritis identified by hypergastrinemia and strongly positive antiparietal antibodies, we explored the overlap between 83 subjects presenting with iron deficiency anemia (IDA), 48 with normocytic indices, and 29 with macrocytic anemia. Compared with macrocytic patients, patients with IDA were 21 years younger (41 +/- 15 years versus 62 +/- 15 years) and mostly women. All groups had a high prevalence of thyroid disease (20%) and diabetes (8%) suggestive of the autoimmune polyendocrine syndrome. Stratification by age cohorts from younger than 20 years to older than 60 years showed a regular and progressive increase in mean corpuscular volume (MCV) from 68 +/- 9 to 95 +/- 16 fl, serum ferritin levels from 4 +/- 2 to 37 +/- 41 microg/L, gastrin level from 166 +/- 118 to 382 +/- 299 pM/L (349 +/- 247 to 800 +/- 627 pg/mL), and a decrease in cobalamin level from 392 +/- 179 to 108 +/- 65 pg/mL. The prevalence of Helicobacter pylori infection was 87.5% at age younger than 20 years, 47% at age 20 to 40 years, 37.5% at 41 to 60 years, and 12.5% at age older than 60 years. These findings challenge the common notion that pernicious anemia is a disease of the elderly and imply a disease starting many years before the establishment of clinical cobalamin deficiency, by an autoimmune process likely triggered by H pylori.

Topics: Adult; Aged; Anemia, Iron-Deficiency; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Disease Progression; Female; Gastrins; Gastritis; Humans; Male; Middle Aged; Reference Values; Vitamin B 12

A relation between food-cobalamin malabsorption and pernicious anemia has been suggested, particularly in the event of food-cobalamin malabsorption related to hypochlorhydric atrophic gastritis.. This work describes three cases of well-documented cobalamin deficiency related to food-cobalamin malabsorption in three women aged 56, 82 and 68 Years who had atrophic gastritis (not associated with Helicobacter pylori infection) and later developed authentic pernicious anemia.. This work illustrates the potential relation between these two disorders responsible for cobalamin deficiency.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Pernicious; Female; Food; Gastritis; Humans; Malabsorption Syndromes; Middle Aged; Vitamin B 12

The prevalence of dementia disorders, cobalamin and/or folate deficiency as well as gastritis increases with age. To investigate whether there is an association between these conditions, plasma homocysteine (Hcy), serum methylmalonic acid, serum cobalamin and blood folate concentrations were measured. Gastritis was indirectly diagnosed by measuring serum antibodies against H,K-ATPase, HELICOBACTER PYLORI and intrinsic factor, using enzyme-linked immunosorbent assays. The studied groups consisted of 47 patients with Alzheimer's disease (AD), 9 with AD pathology in combination with additive vascular lesions, 59 with vascular dementia, 8 who were cognitively impaired, and 101 control cases. Plasma Hcy concentrations were significantly elevated in the dementia groups, with the highest levels in patients with vascular pathology. We conclude that hyperhomocysteinemia is a common finding in patients with dementia disorders of different etiologies. The markers for gastritis did not contribute to an elucidation of a possible connection between this condition, dementia disorders, or cobalamin/folate deficiency.

Topics: Biomarkers; Case-Control Studies; Dementia; Folic Acid; Gastritis; Homocysteine; Humans; Methylmalonic Acid; Middle Aged; Risk Factors; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Pernicious; beta-Thalassemia; Erythrocyte Indices; Female; Folic Acid Deficiency; Gastritis; Hemoglobins; Humans; Middle Aged; Vitamin B 12

The case of a 69 years old female patient is reported, who developed paranoid behaviour due to cobalamin-deficiency without megaloblastosis based on a chronic gastric atrophy. The psychosis showed complete remission after vitamin B 12 supplementation. The discussion leads to the question, whether or not chronic use of tricyclic antidepressants may be one cause of atrophic gastritis. Furthermore, differentialdiagnostic reflections consider the role of cobalamine and folate in the synthesis of monoamine neurotransmitters in the brain.

Topics: Aged; Diagnosis, Differential; Female; Gastritis; Humans; Paranoid Behavior; Psychotic Disorders; Vitamin B 12; Vitamin B 12 Deficiency

Food-cobalamin malabsorption is common in patients with low cobalamin levels. However, characterization of affected subjects has been limited. The aim of this study was to analyze demographic and gastric data in a large study population.. Data were collected prospectively in 202 subjects (43 volunteers and 159 patients) who underwent the egg yolk-cobalamin absorption test (EYCAT). H. pylori status was determined in 167 of the subjects, serum gastrin and antiparietal cell antibody in 158 and pepsinogen (PG) I and PG II levels in 133.. Latin American and black patients had lower EYCAT results than did white or Asian-American ones (p = 0.0001) and had severe food-cobalamin malabsorption (EYCAT < 1%) more often (p = 0.0001). Age correlated inversely with EYCAT results (p = 0.02). H. pylori infection was associated with food-cobalamin malabsorption (p = 0.0001), especially with severe malabsorption where 29/37 subjects (78.4%) were infected. Malabsorption was also associated with higher gastrin levels (p = 0.0001) and lower PG I levels (p = 0.01) and PG I:PG II ratios (p = 0.0001). Multivariate analysis showed that ethnic origin, gastrin levels, H. pylori infection and, to a lesser extent, age were independently associated with the EYCAT results.. Latin American and black patients have food-cobalamin malabsorption more often than do white and Asian-American patients. This association is independent of the malabsorption's association with H. pylori infection, markers of gastritis, such as gastrin, and older age. The patterns of gastric tests suggest that malabsorption may be due to diverse mechanisms, not just atrophic gastritis. The possible role of H. pylori infection in many cases of severe food-cobalamin malabsorption also suggests avenues of treatment and prevention.

Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Asian People; Biomarkers; Black People; Cohort Studies; Comorbidity; Female; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Linear Models; Logistic Models; Malabsorption Syndromes; Male; Middle Aged; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Vitamin B 12; White People

A 54-year-old man was admitted to hospital with dyspnoea, giddiness, lack of appetite and burning sensation in the tongue for 3 years. Gastritis was known from his history. Clinical examination showed jaundice, glossitis, systolic murmur and pallhypesthesia of both legs.. Blood and bone marrow investigations revealed pernicious anaemia. At gastroscopy, fundal gastritis was diagnosed and two small polyps of the fundus were removed. Histologically, one of the two polyps turned out to be a gastric carcinoid type 1 (according to [16]). Additional investigations (x-ray, ultrasound of the abdomen, somatostatin-receptor scintigraphy) did not find any metastases.. With the diagnosis of a pernicious anaemia the patient was treated with vitamin B12. The original symptoms and the anaemia disappeared. Additional therapy of the gastric carcinoid was not necessary. One year after beginning of the treatment, no signs of the gastric carcinoid were found.. In gastric polyps of patients with pernicious anemia neoplastic transformations will often be found. That is why polypectomy should always be done. The best therapy of the gastric carcinoids type 1, which are the most frequently gastric carcinoids, is endoscopic tumour removal. Surgery is the treatment of choice only for gastric carcinoids type 2 to 4. Concerning quality of life and costs, endoscopic treatment is better for patients with gastric carcinoids type 1 than conventional surgical therapy.

Topics: Anemia, Pernicious; Carcinoid Tumor; Diagnosis, Differential; Follow-Up Studies; Gastritis; Gastroscopy; Humans; Male; Middle Aged; Polyps; Stomach; Stomach Neoplasms; Time Factors; Vitamin B 12

To study free- and protein-bound cobalamin absorption and the correlation with atrophic gastritis in healthy middle-aged and older subjects.. A cross-sectional study.. Fifty-two healthy subjects, aged 26 to 87 years, apparently free from conditions known to influence the cobalamin status. Middle-aged subjects were defined as those younger than 65 years of age (median age 57 years) and older subjects as those 65 years and older (median age 75 years).. Protein-bound cobalamin absorption was assessed by 48-hour urinary excretion method following oral administration of scrambled egg yolk, labeled in vivo with 57 Co-cobalamin by injecting a hen with 57 Co-cyanocobalamin. The percentage of 57 Co-cobalamin bound to protein was 65%. Free cobalamin absorption was assessed by 48-hour urinary excretion method following oral administration of crystalline 57 Co-cyanocobalamin. Plasma cobalamin, folate and fasting plasma gastrin, and pepsinogen A and C concentrations were determined.. The median urinary excretion of egg yolk 57 Co-cobalamin in middle-aged subjects was 12.3% (25th and 75th percentiles 10.5%-14.5%) compared with 11.7% (25th and 75th percentiles 9.8%-13.6%) in older subjects (P = .283). The median urinary excretion after administration of free 57 Co-cobalamin in middle-aged subjects was 25.7% (25th and 75th percentiles 20.6%-30.7%) compared with 27.9% (25th and 75th percentiles 21.4%-34.5%) in older subjects (P = .694). Neither egg yolk nor free 57 Co-cobalamin excretion correlated with age. A ratio of pepsinogen A to pepsinogen C less than 1.6, indicating atrophic gastritis, was found in 13 subjects. Within the atrophic gastritis group, 11 subjects had a pepsinogen A concentration greater than or equal to 17 micrograms/L, indicating mild to moderate atrophic gastritis, and two subjects had a pepsinogen A concentration less than 17 micrograms/L, indicating severe atrophic gastritis or gastric atrophy. All subjects had normal fasting plasma gastrin concentrations. Free and egg yolk 57 Co-cobalamin excretions were not reduced in the atrophic gastritis group when compared with the non-atrophic gastritis group. Median plasma cobalamin concentration was not significantly lower in older subjects (P = .205). Nonetheless, plasma cobalamin concentration correlated negatively with age (r = -.36; P = .008).. We demonstrated no significant difference in either free or protein-bound cobalamin absorption between healthy middle-aged and older adults. In addition, no alteration in cobalamin absorption was found in subjects identified as having mild to moderate atrophic gastritis. Therefore, based on our results, the high prevalence of low cobalamin levels in older people cannot be explained by either the aging process or mild to moderate atrophic gastritis.

Topics: Absorption; Adult; Aged; Aged, 80 and over; Aging; Cross-Sectional Studies; Egg Yolk; Female; Gastritis; Hot Temperature; Humans; Male; Middle Aged; Protein Binding; Vitamin B 12

The functional response and phenotypic characterisation of peripheral blood T cells were studied in 41 patients with autoimmune gastritis--nine patients with autoimmune gastritis alone, 11 with untreated pernicious anaemia, and 21 with resolved pernicious anaemia who were taking vitamin B-12. Phenotypic analysis showed no changes in the CD4/CD8 ratio in any group of patients. CD3+ cells were significantly decreased and CD16+ cells were significantly increased in patients with autoimmune gastritis alone. Phytohaemagglutinin induced T cell proliferation, with or without interleukin 2, was reduced in the three groups. T cell proliferation induced by phorbol myristate acetate was normal. Interleukin 2 production of phytohaemagglutinin-stimulated lymphocytes was normal in the three groups. Five patients with pernicious anaemia treated with vitamin B-12 were followed and persistent hypoproliferation of T cells in response to phytohaemagglutinin was observed. The follow up study of the phenotype of these patients showed a significant increase of the CD2+ CD3- lymphocyte population after six months' treatment. In conclusion, the three groups of autoimmune gastritis patients studied have a functional defect in T cells that is independent of B-12 treatment and of the presence of pernicious anaemia.

Topics: Aged; Anemia, Pernicious; Autoimmune Diseases; CD3 Complex; CD4-CD8 Ratio; Chronic Disease; Female; Gastritis; Humans; Lymphocyte Activation; Male; Phenotype; Prospective Studies; Receptors, IgG; T-Lymphocytes; Vitamin B 12

Bacterial overgrowth of the small intestine commonly occurs in association with hypochlorhydria caused by atrophic gastritis or during treatment with omeprazole. The purpose of this study was to determine the clinical significance of bacterial overgrowth on small intestinal absorption and permeability and to evaluate the reliability of noninvasive breath tests to detect bacterial overgrowth in subjects with hypochlorhydria.. Seventeen healthy, elderly subjects with atrophic gastritis or omeprazole treatment (40 mg/day) and documented bacterial overgrowth were studied.. There was no evidence of fat malabsorption (72-hour fecal fat) or clinically significant carbohydrate malabsorption (25 g D-xylose and fecal pH) in any subject. The ratio of lactulose to mannitol excreted was normal in both atrophic gastritis and omeprazole-treated groups. Three subjects in each group had abnormally high alpha 1-antitrypsin clearances. Lactulose (10 g) and glucose (80 g) hydrogen breath tests were only abnormal in 1 out of 17 subjects, whereas the 1 g [14C]D-xylose test was abnormal in 6 out of 17 subjects.. Bacterial overgrowth caused by atrophic gastritis or omeprazole treatment is typically not associated with clinically significant fat or carbohydrate malabsorption. Noninvasive breath tests for bacterial overgrowth are not reliable in subjects with hypochlorhydria.

Topics: Achlorhydria; Aged; Bacteria; Carbohydrates; Colony-Forming Units Assay; Fats; Feces; Female; Gastritis; Humans; Intestinal Absorption; Lactulose; Male; Mannitol; Middle Aged; Omeprazole; Vitamin B 12; Xylose

The presence of autoimmune gastritis was investigated in 54 women with postpartum thyroiditis. Parietal cell antibodies (PCA) specific against H+, K(+)-adenosine triphosphatase (EC 3.6.1.36) were found in 18 women during pregnancy; in 10 of them, a 2-9-fold increase in the PCA level was observed in the postpartum period. At a 5-year follow-up, the initially PCA-positive women still had elevated antibody levels. Hypergastrinemia and low pepsinogen levels were noted in 4 women. In 2 of these women low serum vitamin B12 levels had developed. In 6 of 9 PCA-positive women examined by gastroscopy, biopsy specimens from the gastric body mucosa contained mononuclear cells, mainly T lymphocytes (CD3+) and macrophages (Leu-M3+) combined with an aberrant epithelial expression of HLA-DR. In four patients with chronic gastritis, all parietal cells, as defined by a specific monoclonal antibody, were found to have immunoglobulin G (IgG) deposits by a double-immunostaining method. Three of them had microscopic evidence of atrophy, whereas in 1 patient the body mucosa was intact. In 1 further patient with intact glands at histological examination, the basolateral membrane of some oxyntic glands was coated with IgG. The selective in situ deposition of antibodies associated with histologically intact parietal cells may support the concept that specific autoantibodies participate in the early pathogenesis of parietal cell destruction.

Topics: Adenosine Triphosphatases; Adult; Antibodies; Autoimmune Diseases; Biopsy; Female; Fluorescent Antibody Technique; Follow-Up Studies; Gastric Mucosa; Gastrins; Gastritis; H(+)-K(+)-Exchanging ATPase; Humans; Immunoglobulin A; Immunoglobulin G; Iron; Pepsinogens; Pregnancy; Puerperal Disorders; Thyroiditis, Autoimmune; Vitamin B 12

Gastrointestinal side-effects of prolonged therapy (greater than 2 yr) with the long-acting somatostatin analog octreotide were studied in 10 acromegalic patients. After 2 yr of therapy, 6 of 10 patients had newly developed gallstones, complicated by cholangitis and jaundice in 1. Serum vitamin B-12 concentrations declined in all 10 patients [from 380 +/- 32 to 172 +/- 21 pmol/L (mean +/- SE); P = 0.023] and became abnormally low in 4. Gastric biopsy specimens, obtained during gastroscopy (9 patients), showed moderate to severe active gastritis, with damage to the superficial and deeper layers of the mucosa in 9 of 9 and focal atrophy in 7 of 9 patients. Campylobacter pylori was found in the antral mucosa in 8 of 9 patients. Although information is lacking on similar studies in untreated acromegalic patients, we suggest that patients receiving chronic octreotide therapy be closely monitored for these and possible other side-effects related to gastrointestinal actions of octreotide.

Topics: Acromegaly; Adult; Aged; Atrophy; Cholelithiasis; Epithelium; Female; Gastric Mucosa; Gastritis; Gastrointestinal Diseases; Helicobacter pylori; Humans; Male; Middle Aged; Octreotide; Vitamin B 12

Topics: Aged; Aged, 80 and over; Female; Gastritis; Gastritis, Atrophic; Health Status Indicators; Humans; Male; Vitamin B 12

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; Cobalt Radioisotopes; Female; Gastritis; Gastritis, Atrophic; Humans; Intestinal Absorption; Male; Middle Aged; Vitamin B 12

Topics: Aftercare; Dumping Syndrome; Esophagitis, Peptic; Folic Acid; Gastrectomy; Gastritis; Gastrointestinal Hemorrhage; Gastroscopy; Humans; Iron; Neoplasm Recurrence, Local; Nutritional Requirements; Vitamin B 12

Topics: Adolescent; Anemia, Pernicious; Gastric Acid; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Humans; Intestinal Absorption; Male; Vitamin B 12

Serum vitamin B12 concentration, parietal cell antibodies (PCA), peak acid output vitamin B12 resorption capacity were determined in 76 patients (age 23 to 82 years). Gastroscopy was performed on all of these patients; guided biopsy was taken from 70 of them. No influence of the inflammatory changes in the gastric mucosa, sex or the presence of PCA on the serum vitamin B12 concentration were demonstrable in our patients, who all revealed a vitamin B12 resorption in the normal range. In particular we were unable to confirm the observation of Döscherholmen et al. (5) of a fall in serum vitamin B12 concentration with increasing age or decreasing PAO. Hence the estimation of the serum vitamin B12 concentration cannot be used as a screening test for selecting those patients suffering from chronic atrophic gastritis and achlorhydria, who should be monitored by gastroscopy and biopsy because of an increased risk of gastric cancer.

Topics: Achlorhydria; Adult; Aged; Aging; Female; Gastric Juice; Gastritis; Gastritis, Atrophic; Humans; Male; Middle Aged; Regression Analysis; Vitamin B 12; Vitamin B 12 Deficiency

A method of assay for the circulating intrinsic factor antibody type I (IFA1) and for the serum vitamin-B12 level by the use of hog intrinsic factor has been developed. The results, the sources of error being taken into consideration, are in agreement with the values obtained by the generally accepted methods of ARDEMAN--CHANARIN for IFA1 and of WIDE--KILLANDER for the serum vitamin-B12 level. Parallel with the increase in the frequency of circulating IFA1, the serum vitamin-B12 level was found to decline in normal individuals as well as in patients with atrophic gastritis or pernicious anaemia. The method is suitable for the assessment of vitamin-B12 deficiency and lends itself to screening of patients tending to pernicious anaemia.

Topics: Adult; Anemia, Pernicious; Animals; Antibodies; Cattle; Female; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Swine; Vitamin B 12

Gastric morphology, function, and immunology was studied in 68 patients with pernicious anemia (PA), 183 of their first-degree relatives, and 354 control subjects. The PA relatives and controls were comparable in age and sex distribution. In both groups, mean gastric acid output decreased and mean fasting serum gastrin levels and the prevalence of atrophic gastritis increased with age. The total prevalence of chronic gastritis was similar in the two groups, but severe atrophic gastritis of the body of the stomach (AGB), achlorhydria, parietal cell antibodies, and a raised fasting serum gastrin level were significantly more common in PA relatives than in controls. Of the PA relatives 23 had severe AGB which was indistinguishable from the gastric mucosal lesion found in PA probands and was, as a rule, accompanied by several other characteristics of type A gastritis. These included a normal antrum (78%), slight or absent inflammatory cell infiltration in the gastric mucosa (70%), achlorhydria (91%), high fasting serum gastrin level (83%), parietal cell antibodies (65%), and intrinsic factor antibodies (22%). The mean age and the proportion of subjects with slight and moderate AGB of all AGB subjects was significantly lower in PA relatives than in controls. This suggests an early onset and a rapid progression from mild to severe AGB in PA relatives. Thus, the PA relatives appear to consist of two populations, one with a high and one with little or no proneness to severe AGB. This bimodal distribution suggests the participation of a single major factor, probably genetic, in the pathogenesis of severe AGB in PA relatives.

Topics: Adolescent; Adult; Age Factors; Anemia, Pernicious; Atrophy; Autoantibodies; Consanguinity; Female; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Humans; Intestines; Intrinsic Factor; Male; Metaplasia; Middle Aged; Pyloric Antrum; Vitamin B 12

A patient with granulomatous gastritis is described. Two years after the presentation of his gastric disease he developed pernicious anemia. Lack of intrinsic factor production secondary to Crohn's disease of the stomach is felt to be the cause of his Vitamin B12 malabsorption.

Topics: Adult; Anemia, Pernicious; Crohn Disease; Gastritis; Humans; Intrinsic Factor; Male; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Megaloblastic; Autoantibodies; Diagnosis, Differential; FIGLU Test; Gastric Juice; Gastritis; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Intrinsic Factor; Prognosis; Vitamin B 12

Topics: Body Weight; Female; Gastrectomy; Gastric Mucosa; Gastritis; Humans; Infant; Vitamin B 12

During 1 year 725 consecutive patients admitted to a geriatric unit were investigated for anaemia. 51% of men had haemoglobin levels below 13.5 g/dl and 41% of women had levels below 12 g/dl. 657 patients had an azuresin tubeless test meal following an augmented dose of histamine acid phosphate and 450 (68%) had achlorhydria. Gastric biopsies were performed on 240 of the patients with achloryhdria and 201 satisfactory biopsies were obtained. These were graded into five categories: (1) normal; (2) surface gastritis; (3) diffuse gastritis; (4) chronic atrophic gastritis, and (5) chronic atrophic gastritis with intestinal metaplasia. The grades of mucosal change could not be correlated with the presence or absence of anaemia, the state of gastric function as measured by the Schilling test for absorption of vitamin B12, or the level of vitamin B12 in the serum.

Topics: Achlorhydria; Age Factors; Aged; Anemia; Female; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Male; Schilling Test; Vitamin B 12

Twenty-one patients (4 females and 17 males) were re-examined 20 years after partial gastrectomy for benign peptic ulcer. Different stages of morphological change in the gastric stump mucosa were compared with haematological parameters as well as with gastric acid and IF secretions. Biopsy specimens were taken by the direct vision technique. Haematological values including also serum vitamin B12, folate and Schilling test were determined. Gastric acid and IF secretions were lower in all patients with "selective parietal cell atrophy" in the gastric mucosa compared with those of other patients. Serum B12 and Schilling test values showed the same tendency. The present study indicates that it is possible to determine the gastric function dependent on parietal cells according to morphological criteria.

Topics: Atrophy; Female; Gastrectomy; Gastric Juice; Gastric Mucosa; Gastritis; Hemoglobins; Humans; Intrinsic Factor; Male; Postgastrectomy Syndromes; Schilling Test; Vitamin B 12

Five of 33 patients with dermatitis herpetiformis (DH) were found to have gastric parietal cell antibody in their sera, whereas it was not found in 30 healthy controls of comparable age distribution. Fifteen of the patients with DH underwent further studies to investigate the histological and functional state of their gastric mucosa. Atrophic gastritis was found in all five patients whose sera contained gastric parietal cell antibody and in three of 11 patients with no antibody in their sera. In addition, there was marked impairment of acid secretion in the DH group as a whole, but, apart from one patient with overt pernicious anaemia (PA), there was no evidence of malabsorption of B12.

Topics: Adolescent; Adult; Aged; Anemia, Pernicious; Atrophy; Autoantibodies; Dermatitis Herpetiformis; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Male; Middle Aged; Pentagastrin; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Adult; Agammaglobulinemia; Anemia, Hypochromic; Gastritis; Humans; Intestinal Absorption; Male; Vitamin B 12

Forty-two patients with pernicious anemia (PA) and 35 patients with achlorhydria but without PA were investigated by means of serum gastrin determination and estimation of circulating parietal cell and thyroidal autoantibodies. In 38 of the 77 patients, gastroscopic and histopathological examinations of the antral and corpus mucosa were performed. The patient groups were similar with regard to distribution of high and normal serum gastrin levels, the frequencey of autoantibodies and antrum-sparing atrophic gastritis. In the present selection of patients, therefore, the achlorhydria group was supposed to represent a precursor state of the group with PA. A minor proportion of patients with severe atrophic gastritis of the antrum as well as of the corpus mucosa was found in the two groups.

Topics: Achlorhydria; Adult; Aged; Anemia, Pernicious; Autoantibodies; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Fasting serum pyridoxal was assayed by an automated microbiological system in 60 patients investigated for dyspepsia, patients with active peptic ulceration being excluded from the study. Gastritis was present in 30 patients, gastric carcinoma in 16, six patients had benign polyps, and, in eight patients, radiology, endoscopy, and biopsy failed to shown any abnormality. Of the 52 patients with gastric pathology, 44 had a low serum pyridoxal.

Topics: Adult; Aged; Biopsy; Endoscopy; Female; Folic Acid; Gastritis; Humans; Intestinal Polyps; Male; Middle Aged; Pyridoxal; Radiography; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Addisonian pernicious anemia (PA) usually develops after age 50. These PA patients are immunocompetent and usually manifest gastric autoimmunity. The prevalence of PA is increased about 10-fold with multiple myeloma and 250-fold in adults with primary immunoglobulin deficiency. Atrophic gastritis develops at an unusually early age with primary immunoglobulin deficiency but not with myeloma. Family history with myeloma is often relevant to PA. Atrophic gastritis develops in both syndromes without gastrict autoantibody production.

Topics: Aging; Anemia, Pernicious; Antibodies; Binding, Competitive; Child, Preschool; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Hemagglutination Tests; Humans; Hypersensitivity, Delayed; Immunodiffusion; Immunoglobulins; Infant; Intestinal Secretions; Intrinsic Factor; Multiple Myeloma; Radioimmunoassay; Thyroid Gland; Vitamin B 12; Vitamin B 12 Deficiency

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

Topics: Achlorhydria; Anemia, Pernicious; Autoantibodies; Autoimmune Diseases; Gastritis; Humans; Malabsorption Syndromes; Vitamin B 12

Topics: Chromatography; Cobalt Radioisotopes; Gastric Juice; Gastric Mucosa; Gastritis; Glycosaminoglycans; Humans; Peptic Ulcer; Vitamin B 12

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: Achlorhydria; Anemia, Megaloblastic; Anorexia Nervosa; Body Weight; Bone Marrow Cells; Celiac Disease; Diarrhea; Gastritis; Hemoglobinometry; Humans; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Vitamin B 12; Zimbabwe

Topics: Biopsy; Celiac Disease; Cobalt Radioisotopes; Colitis, Ulcerative; Colostomy; Crohn Disease; Dermatitis Herpetiformis; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Ileostomy; Intestinal Absorption; Jejunum; Obesity; Pentagastrin; Schilling Test; Secretory Rate; Stimulation, Chemical; Vitamin B 12

The administration of prednisolone did not affect absorption of vitamin B(12) and gastric secretion of intrinsic factor in nine subjects with normal gastric mucosa, or in five with chronic superficial gastritis. No gastric morphological changes were observed in either group. In contrast, four of seven patients with pernicious anaemia showed improvement in absorption of vitamin B(12) during prednisolone administration for periods of two to 10 months. No consistent changes in gastric mucosal morphology were noted. An additional five patients were studied intensively during one month of prednisolone administration. In three, absorption of vitamin B(12) was restored to within the normal range between eight and 13 days after the commencement of the drug. The improvement was not paralleled by enhancement of secretion of intrinsic factor or other vitamin B(12) binders. Suppression of intrinsic factor antibodies in serum and gastric juice did not occur consistently in those patients showing a functional response.

Topics: Anemia, Pernicious; Antibodies; Binding Sites; Cobalt Isotopes; Complement Fixation Tests; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intestinal Absorption; Intrinsic Factor; Male; Prednisolone; Stomach; Vitamin B 12

Topics: Adolescent; Adult; Anemia, Pernicious; Carbachol; Cobalt Radioisotopes; Coffee; Diagnosis, Differential; Fasting; Female; Gastric Acidity Determination; Gastric Juice; Gastritis; Histamine; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Schilling Test; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Antibodies; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Deficiency Diseases; Fats; Feces; Female; Folic Acid; Gastric Juice; Gastric Mucosa; Gastritis; Humans; India; Intestinal Absorption; Intrinsic Factor; Malabsorption Syndromes; Male; Middle Aged; Vitamin B 12; Xylose

An investigation of 102 men comprising alcoholics, patients with non-ulcer dyspepsia, and healthy controls is reported. It demonstrates that alcohol is a cause of chronic gastritis and the severity of the mucosal lesion is directly related to the duration of excess drinking. Contrary to popular belief, chronic gastritis does not give rise to symptoms. The effect of alcohol on the gastric mucosa is a direct one and is not mediated by malnutrition, hepatic damage, intestinal malabsorption, anaemia, ascorbic acid deficiency, or any disturbance in immune tolerance. The natural history of chronic gastritis is described, involving an initial hypertrophy and hyperfunction of the gastric mucosa, followed by atrophy and hypofunction. Cigarette smoking is confirmed as another cause of chronic gastritis. The non-ulcer dyspepsia syndrome is unrelated to chronic gastritis.

Topics: Adolescent; Adult; Alcoholism; Atrophy; Chronic Disease; Dyspepsia; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Hypertrophy; Male; Middle Aged; Nutrition Disorders; Radiography; Smoking; Time Factors; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Autoantibodies; Cobalt Isotopes; Female; Gastric Juice; Gastritis; Humans; Immunodiffusion; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Intrinsic Factor; Lymphocytes; Male; Middle Aged; Radioisotope Dilution Technique; Schilling Test; Vitamin B 12

Topics: Anemia, Pernicious; Antibody Formation; Autoantibodies; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Monocytes; Stomach; Vitamin B 12

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

Gastric carcinoma was detected nine, 10, 18, and 21 years after the biopsy diagnosis of atrophic gastritis in four patients of a group of 40. The gastritis was presumed to be of the simple type. Tests of vitamin B(12) absorption in three patients gave normal results, no gastric autoantibodies were detected in the two patients tested, in all patients histological examination of the gastrectomy specimens revealed a multifocal gastritis differing from the diffuse gastritis of pernicious anaemia and in three patients the gastritis affected the antrum, which is unusual in pernicious anaemia. The 10% incidence of gastric carcinoma in 40 patients with simple atrophic gastritis followed for a mean period of 15 years is equivalent to that previously described in pernicious anaemia. However, in view of the relative incidence of atrophic gastritis with and without pernicious anaemia in the general adult population, it emerges that atrophic gastritis without pernicious anaemia is numerically the more important precursor of gastric carcinoma.

Topics: Adult; Anemia, Pernicious; Atrophy; Autoantibodies; Biopsy; Female; Follow-Up Studies; Gastrectomy; Gastritis; Humans; Intestinal Absorption; Male; Middle Aged; Precancerous Conditions; Pylorus; Stomach Neoplasms; Vitamin B 12

Topics: Adolescent; Adult; Age Factors; Aged; Alcohol Drinking; Antibodies; Biopsy; Blood Group Antigens; Coffee; Feeding Behavior; Female; Finland; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Pedigree; Sex Factors; Smoking; Vitamin B 12

Fasting gastrin levels in serum were measured in 49 patients with different types of chronic gastritis and in matched controls. In 15 patients with established pernicious anaemia the mean (+/- S.E. of mean) level of gastrin was greatly raised (699 +/- 99 pg/ml). In 17 patients with chronic atrophic gastritis, seropositive for parietal cell antibody but with adequate vitamin-B(12) absorption, the level was also raised (476 +/- 74 pg/ml). By contrast, in "simple" atrophic gastritis seronegative for parietal cell antibody the gastrin levels were significantly lower for both diffuse atrophic gastritis (129 +/- 31 pg/ml) and multifocal gastritis (14 +/- 4 pg/ml). These levels were similar to those in the controls (46 +/- 7 pg/ml).The mechanism of the raised gastrin levels remains uncertain, but neither achlorhydria nor in vivo action of the parietal cell antibody wholly accounted for the hypergastrinaemia.We conclude that hypergastrinaemia is characteristic of gastritis associated with autoimmune reactions to gastric antigens and pernicious anaemia and that a raised serum gastrin is a useful marker of the type of gastritis that tends to progress to the gastric lesion of pernicious anaemia. The findings suggest that this type of gastritis is an essentially different disease from "simple" atrophic gastritis, and the differences in gastrin levels may be due to sparing of the antral mucosa in the autoimmune type but not in "simple" gastritis.

Topics: Achlorhydria; Aged; Anemia, Pernicious; Antibodies; Antigens; Autoimmune Diseases; Chronic Disease; Female; Gastric Mucosa; Gastrins; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Topics: Child; Child Development; Female; Follow-Up Studies; Gastrectomy; Gastritis; Growth; Humans; Hypertrophy; Malabsorption Syndromes; Postgastrectomy Syndromes; Prognosis; Protein-Losing Enteropathies; Stomach Diseases; 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: Adult; Aged; Anemia, Hypochromic; Anemia, Macrocytic; Biopsy; Bone and Bones; Calcium; Celiac Disease; Disability Evaluation; Dumping Syndrome; Female; Folic Acid Deficiency; Follow-Up Studies; Gastric Mucosa; Gastritis; Humans; Lactose Intolerance; Male; Middle Aged; Nutrition Disorders; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Chromatography, Gel; Chromatography, Ion Exchange; Chromium Isotopes; Electrophoresis; Feces; Gastrectomy; Gastric Juice; Gastritis; Guinea Pigs; Humans; Hydrogen-Ion Concentration; Intestinal Absorption; Intestinal Mucosa; Intrinsic Factor; Liver; Postoperative Complications; Swine; Vitamin B 12

Topics: Achlorhydria; Adolescent; Anemia, Pernicious; Atrophy; Biopsy; Erythrocyte Count; Gastric Mucosa; Gastritis; Hemoglobins; Humans; Male; Oral Manifestations; Radiography; Vitamin B 12

Topics: Anemia, Macrocytic; Cobalt Isotopes; Feces; Folic Acid; Gastritis; Humans; In Vitro Techniques; Male; Vitamin B 12

Topics: Achlorhydria; Dermatitis Herpetiformis; Gastritis; Humans; Malabsorption Syndromes; Pemphigus; Vitamin B 12; Vitamin B 12 Deficiency

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; Chronic Disease; Crohn Disease; Diagnosis, Differential; Gastric Juice; Gastritis; Humans; Ileum; Intestinal Mucosa; Male; Middle Aged; Polyps; Stomach; Stomach Diseases; Stomach Neoplasms; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Antigen-Antibody Reactions; Atrophy; Biopsy; Complement System Proteins; Female; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Male; Middle Aged; Vitamin B 12

Topics: Anemia, Pernicious; Antibody Formation; Chromatography, Gel; Cobalt Isotopes; Female; Gastritis; Humans; Intrinsic Factor; Male; Methods; Vitamin B 12

Topics: Cobalt Isotopes; Duodenal Ulcer; Gastritis; Humans; Intestinal Absorption; Peptic Ulcer; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Cobalt Isotopes; Gastrectomy; Gastritis; Humans; Intestinal Absorption; Iron; Iron Isotopes; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Asian People; Atrophy; Autoantibodies; Female; Gastritis; Hong Kong; Humans; Hyperthyroidism; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Stomach; Vitamin B 12

Topics: Anemia, Pernicious; Antibodies; Cobalt Isotopes; Gastritis; Humans; Intrinsic Factor; Stomach Neoplasms; Vitamin B 12

Topics: Achlorhydria; Anemia, Pernicious; Gastric Juice; Gastrins; Gastritis; Histamine; Humans; Intrinsic Factor; Radioimmunoassay; Schilling Test; Vitamin B 12

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; Autoantibodies; Biopsy; Complement Fixation Tests; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Microsomes; Vitamin B 12

Topics: Adolescent; Adult; Aged; Anemia, Hypochromic; Autoantibodies; Female; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intestinal Absorption; Iron; Male; Middle Aged; Pepsin A; Secretory Rate; Vitamin B 12

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

Topics: Achlorhydria; Aged; Anemia, Pernicious; Animals; Antigen-Antibody Reactions; Atrophy; Biopsy; Diabetes Mellitus; Female; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Immune Sera; Intrinsic Factor; Male; Middle Aged; Prednisolone; Rats; Regeneration; Reticulocytes; Schilling Test; Stomach; Stomach 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: Aged; Anemia, Pernicious; Autoantibodies; Body Height; Body Weight; Female; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Iron; Ischemia; Male; Middle Aged; Peptic Ulcer; Polycythemia Vera; Stomach Ulcer; Vitamin B 12

Topics: Animals; Antibody Formation; Antigens; Autoantibodies; Autoradiography; Chromatography, Ion Exchange; Cobalt Isotopes; Dogs; Gastric Juice; Gastric Mucosa; Gastritis; Immune Sera; Immunodiffusion; Immunoelectrophoresis; Intestinal Absorption; Protein Binding; Proteins; Rabbits; Schilling Test; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Antibodies, Antinuclear; Antigen-Antibody Reactions; Atrophy; Autoantibodies; Female; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Stomach Diseases; Vitamin B 12

Topics: Adult; Anemia, Pernicious; Female; Gastritis; Humans; Hyperthyroidism; India; Intrinsic Factor; Thyroid Function Tests; Vitamin B 12

Topics: Aged; Female; Gastritis; Humans; Influenza, Human; Male; Middle Aged; Vitamin B 12

Topics: Achlorhydria; Adult; Anemia, Pernicious; Diagnosis, Differential; Gastric Juice; Gastritis; Histamine; Humans; Intrinsic Factor; Schilling Test; Vitamin B 12

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

Topics: Atrophy; Cobalt Isotopes; Dexamethasone; Gastric Mucosa; Gastritis; Humans; Intestinal Mucosa; Male; Metaplasia; Middle Aged; Vitamin B 12

Topics: Anemia, Pernicious; Autoantibodies; Fluorescent Antibody Technique; Gastric Mucosa; Gastritis; Humans; Intestinal Absorption; Intrinsic Factor; Postgastrectomy Syndromes; Vitamin B 12

Topics: Adult; Aged; Amino Acids; Arthritis, Rheumatoid; Biliary Dyskinesia; Dyspepsia; Female; Folic Acid; Gallbladder Diseases; Gastritis; Humans; Liver Diseases; Male; Middle Aged; Niacinamide; Vitamin B 12

Topics: Aged; Antibodies; Atrophy; Biopsy; Fluorescent Antibody Technique; Gastric Juice; Gastric Mucosa; Gastritis; Histamine; Humans; Intrinsic Factor; Iron; Male; Middle Aged; Schilling Test; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Anemia, Pernicious; Female; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Hexoses; Humans; Intestinal Absorption; Intrinsic Factor; Male; Middle Aged; Pepsin A; Secretory Rate; Vitamin B 12

Topics: Adult; Colitis; Female; Gastric Mucosa; Gastritis; Histidine; Humans; Intestinal Mucosa; Male; Methods; Pantothenic Acid; Peptic Ulcer; Vitamin B 12

Topics: Adult; Aged; Chronic Disease; Female; Gastric Acidity Determination; Gastritis; Humans; Male; Middle Aged; Vitamin B 12

Topics: Blood; Gastric Acidity Determination; Gastritis; Humans; Radiography; Radioisotopes; Vitamin B 12

Topics: Atrophy; Gastric Acidity Determination; Gastritis; Histamine; Humans; Intrinsic Factor; Urine; Vitamin B 12

Topics: Anemia, Pernicious; Biopsy; Follow-Up Studies; Gastric Mucosa; Gastritis; Gastroscopy; Hemoglobins; Humans; Metaplasia; Radiography; Schilling Test; Stomach; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; DNA; Gastric Lavage; Gastric Mucosa; Gastritis; Humans; Saliva; Sputum; Vitamin B 12

Topics: Achlorhydria; Adolescent; Adult; Anemia, Pernicious; Antibodies; Biopsy; Blood; Child; Child, Preschool; Female; Gastric Juice; Gastritis; Humans; Hydrochloric Acid; In Vitro Techniques; Infant; Intrinsic Factor; Male; Stomach Diseases; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Autoantibodies; Autoimmune Diseases; Biological Assay; Biopsy; Cobalt Isotopes; Complement Fixation Tests; Fluorescent Antibody Technique; Folic Acid; Gastric Acidity Determination; Gastritis; Gastritis, Atrophic; Humans; Intestinal Absorption; Pathology; Thyroid Gland; Vitamin B 12

Topics: Atrophy; Biopsy; Carbohydrate Metabolism; Colitis; Colitis, Ulcerative; Electrons; Feces; Fluids and Secretions; Gastritis; Intestinal Absorption; Intestine, Small; Lipid Metabolism; Microscopy; Microscopy, Electron; Pathology; Stomach; Vitamin B 12; Xylose

Topics: Anemia, Pernicious; Antibodies; Biopsy; Diagnosis; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastrins; Gastritis; Histamine; Humans; Immunochemistry; Intestinal Absorption; Intrinsic Factor; Pharmacology; Vitamin B 12

Topics: Adult; Aged; Anemia, Pernicious; Antibodies; Cobalt Isotopes; Gastric Acidity Determination; Gastritis; Histamine; Humans; Immunoassay; Intrinsic Factor; Middle Aged; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Autoantibodies; Autoimmunity; Biopsy; Blood Chemical Analysis; Fluorescent Antibody Technique; Gastric Acidity Determination; Gastric Mucosa; Gastritis; Humans; Iron; Parietal Cells, Gastric; Pathology; Vitamin B 12

Topics: Anemia, Pernicious; Biomedical Research; Corrinoids; Diagnosis, Differential; Gastritis; Humans; Intrinsic Factor; Research; Stomach Neoplasms; Vitamin B 12

Topics: Anemia, Pernicious; Animals; Cestoda; Cestode Infections; Corrinoids; Erythrocyte Count; Gastritis; Humans; Intrinsic Factor; Physiology; Schilling Test; Vitamin B 12

Topics: Aging; Gastric Acidity Determination; Gastric Juice; Gastric Mucosa; Gastritis; Humans; Intrinsic Factor; Schilling Test; Urine; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Blood; Carbachol; Gastric Juice; Gastritis; Gastritis, Atrophic; Geriatrics; Histamine; Humans; Hydrochloric Acid; Intrinsic Factor; Pathology; Pharmacology; Vitamin B 12

Topics: Aminosalicylic Acid; Aminosalicylic Acids; Biopsy; Drug Therapy; Feces; Gastric Mucosa; Gastritis; Humans; Intestine, Small; Intestines; Lipid Metabolism; Malabsorption Syndromes; Toxicology; Vitamin B 12; Vitamin B 12 Deficiency; Xylose

Topics: Bodily Secretions; Cathepsins; Cobalt Isotopes; Corrinoids; Gastric Juice; Gastric Mucosa; Gastritis; Histamine Release; Humans; Metabolism; Pepsin A; Urine; Vitamin B 12

Topics: Anemia; Anemia, Pernicious; Atrophy; Bodily Secretions; Cathepsins; Cobalt Isotopes; Gastric Juice; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Histamine Release; Humans; Pepsin A; Urine; Vitamin B 12

Topics: Biopsy; Blood Chemical Analysis; Celiac Disease; Gastric Acidity Determination; Gastric Mucosa; Gastritis; Humans; Steatorrhea; Vitamin B 12

Topics: Achlorhydria; Anemia; Anemia, Pernicious; Atrophy; Chemical Phenomena; Chemistry; Erythropoiesis; Gastric Juice; Gastric Mucosa; Gastritis; Gastrointestinal Hormones; Humans; Intrinsic Factor; Metabolism; Peptic Ulcer; Pharmacology; Physiology; Vitamin B 12

Topics: Anemia; Anemia, Aplastic; Blood Chemical Analysis; Gastritis; Hematopoiesis; Humans; Peptic Ulcer; Postgastrectomy Syndromes; Vitamin B 12

Topics: Anemia, Macrocytic; Anemia, Pernicious; Cobalt Isotopes; Gastritis; Humans; Intestinal Absorption; Isotope Labeling; Malabsorption Syndromes; Vitamin B 12

Topics: Atrophy; Duodenal Ulcer; Gastritis; Gastritis, Atrophic; Humans; Intrinsic Factor; Polyps; Stomach Diseases; Stomach Neoplasms; Stomach Ulcer; Vitamin B 12

Topics: Atrophy; Biopsy; Gastric Juice; Gastric Mucosa; Gastritis; Gastritis, Atrophic; Humans; Intestinal Absorption; Intestines; Stomach Diseases; Suction; Vitamin B 12

Topics: Corrinoids; Gastritis; Gastritis, Atrophic; Humans; Vitamin B 12

Topics: Female; Gastritis; Humans; Hyperemesis Gravidarum; Pregnancy; Pregnancy Complications; Vitamin B 12; Vitamin B Complex; Vomiting

Topics: Anemia; Anemia, Pernicious; Gastric Mucosa; Gastritis; Humans; Vitamin B 12

Topics: Biochemical Phenomena; Gastritis; Gastritis, Atrophic; Vitamin B 12