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Clinical and Developmental Immunology
Volume 2012 (2012), Article ID 520970, 5 pages
http://dx.doi.org/10.1155/2012/520970
Clinical Study

Clinical Usefulness of the Serological Gastric Biopsy for the Diagnosis of Chronic Autoimmune Gastritis

1Laboratorio Analisi Chimico-Cliniche, Ospedale Civile, 35013 Cittadella, Italy
2Laboratorio di Patologia Clinica, Azienda Ospedaliero-Universitaria, Policlinico di Bari, 70124 Bari, Italy
3Allergologia e Immunologia Clinica, Azienda Ospedaliera S. Maria degli Angeli, 33170 Pordenone, Italy
4Allergologia e Immunopatologia, Azienda Ospedaliero-Universitaria S. Maria della Misericordia, 33100 Udine, Italy
5Laboratorio di Patologia Clinica, Azienda Ospedaliera S. Maria degli Angeli, 33170 Pordenone, Italy
6Laboratorio di Patologia Clinica, Ospedale San Antonio, 33028 Tolmezzo, Italy

Received 14 September 2012; Accepted 18 October 2012

Academic Editor: Dimitrios P. Bogdanos

Copyright © 2012 Antonio Antico et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To assess the predictive value for chronic autoimmune gastritis (AIG) of the combined assay of anti-parietal-cell antibodies (PCA), anti-intrinsic-factor antibodies (IFA), anti-Helicobacter pylori (Hp) antibodies, and measurement of blood gastrin. Methods. We studied 181 consecutive patients with anemia, due to iron deficiency resistant to oral replacement therapy or to vitamin B12 deficiency. Results. 83 patients (45.8%) tested positive for PCA and underwent gastroscopy with multiple gastric biopsies. On the basis of the histological diagnosis, PCA-positive patients were divided into 4 groups: (1) 30 patients with chronic atrophic gastritis; they had high concentrations of PCA and gastrin and no detectable IFA; (2) 14 subjects with metaplastic gastric atrophy; they had high PCA, IFA, and gastrin; (3) 18 patients with nonspecific lymphocytic inflammation with increased PCA, normal gastrin levels, and absence of IFA; (4) 21 patients with multifocal atrophic gastritis with “borderline” PCA, normal gastrin, absence of IFA and presence of anti-Hp in 100% of the cases. Conclusions. The assay of four serological markers proved particularly effective in the diagnostic classification of gastritis and highly correlated with the histological profile. As such, this laboratory diagnostic profile may be considered an authentic “serological biopsy.”