In this patient, the elevated serum gastrin level and the presence of antiintrinsic factor antibodies pointed to pernicious anemia.
The term pernicious anemia, which was coined by a German physician in the 19th century, is
It is thought to be an autoimmune disorder that results in antibody production against both intrinsic factor and the gastric parietal cells that make the factor. About 80% of patients with pernicious anemia have antibodies against parietal cells, and about 66% have antibodies against intrinsic factor. Parietal cell antibodies are not specific for pernicious anemia; they can occur in any patient with type A atrophic gastritis, a condition that is especially common in the elderly. Thus, parietal cell antibody testing is not appropriate for the diagnosis of pernicious anemia. Intrinsic factor antibody testing, on the other hand, is about 95% specific for pernicious anemia but has a low sensitivity.
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