General Gastro

Question 1

When B12 is low and you suspect pernicious anaemia secondary to autoimmune gastritis, which tests should you consider?

Answer 1

Anti-Intrinsic Factor Abs: occur in 60% of those with PA.
A negative result does not exclude PA.

Anti-Parietal Cell Abs: occur in >90% of those with autoimmune gastritis.

Gastric biopsy: consider in a young person (M.

If anti-parietal cell NEGATIVE but anti-IF Ab POSITIVE:
- If megaloblastic anaemia and low B12 = serological e/o PA. However, consider confirming Dx with gastric Bx in person repeat in 6 months with serum gastrin levels.

(Per Immunology Society)