A case of Addison-Biermer type pernicious anemia associated with intrinsic factor autoantibodies in serum and gastric juice.

Abstract

The case of a 65-year-old woman with pernicious anemia associated with intrinsic factor autoantibodies in serum and gastric juice is presented. The diagnosis was established from the characteristic hematologic findings including macrocytic anemia, megaloblastic marrow, gastric mucosal atrophy, achlorhydria, a positive Schilling's test and rapid clinical improvement following intensive V. B₁₂ treatment. Two types of intrinsic factor antibodies, blocking and binding antibodies, were found in serum and gastric juice by the gel filtration method, charcoal adsorption, paper electrophoresis, and radioimmuno-diffusion analyses. The antibody titers were much higher in gastric juice when compared to those in serum. Analysis of the immunoglobulin classes has disclosed the coexistenceof IgG and IgA binding antibodies. It was speculated that the appearance of the autoantibodies against endogenous intrinsic factor was the initiating event in the development of pernicious anemia in the present case.