[The importance of hypergastrinemia in the diagnosis of Biermer's disease in the adult].

Abstract

Achlorhydria that is due to antrum sparring atrophic gastritis is a characteristic finding in pernicious anemia. As a consequence of this achlorhydria serum gastrin level rise. Usually several signs are required for assessing a pernicious anemia: megaloblastic anemia, low serum cobalamin level, positivity of a Schilling test, low level of intrinsic factor in the gastric juice, existence of anti-intrinsic factor antibodies in plasma and/or in gastric juice. In this study the usefulness of the serum gastrin level is assessed. We report here the results in investigating sixteen patients with a pernicious anemia. All had: megaloblastic changes on bone marrow examination, serum cobalamin level lower than 150 pg/ml. For 14 patients the performed Schilling test was positive. For 2, no Schilling test was done, but anti-intrinsic factor antibodies were elevated. Serum gastrin levels were higher than 150 pg/ml (254 to 1770 pg/ml). In our patients with pernicious anemia, as a result of hypo or achlorhydria, serum gastrin increase was higher than in any other cause of hypochlorhydria: anti-acid treatment, vagotomy ... Measurement of serum gastrin is easy. High levels are simple to explain if found together with a sparing antrum atrophic gastritis and/or a low level of serum cobalamin. Serum gastrin measurement may be a cornerstone of rapid and reliable diagnosis of pernicious anemia.

• Authors: M Mongin, J R Harle, P J Weiller
• Journal: Annales de gastroenterologie et d'hepatologie (Ann Gastroenterol Hepatol (Paris)) 1993 Jan-Feb Vol. 29 Issue 1 Pg. 42-5 ISSN: 0066-2070 [Print] France
• Vernacular Title: Place de l'hypergastrinémie dans le diagnostic de la maladie de Biermer de l'adulte.
• PMID: 8442653 (Publication Type: English Abstract, Journal Article, Review)

Chemical References

• Gastrins
• Vitamin B 12

Topics

• Anemia, Pernicious (blood, diagnosis, epidemiology)
• Biopsy (standards)
• Bone Marrow Examination (standards)
• Comorbidity
• Endoscopy, Gastrointestinal (standards)
• France (epidemiology)
• Gastrins (blood)
• Humans
• Schilling Test (standards)
• Sensitivity and Specificity
• Vitamin B 12 (blood)