The aim of this study was to assess the frequency of corpus
gastritis with severe
atrophy (CGA), pernicious anaemia and combined severe
atrophy of antrum and corpus by non-invasive methods (i.e. determination of low serum
pepsinogen A (
PgA) and serum
gastrin) in outpatients with RA (n = 249), compared to outpatients with other
rheumatic diseases (n = 181) and outpatients with chronic non-
rheumatic diseases (n = 429). In addition we investigated whether
NSAIDs could cause or prevent CGA. A low serum
PgA level (< 17 micrograms/l), indicating
pentagastrin-refractory
achlorhydria in patients without gastric resection, was found in 13 patients (5.2%; 95% Confidence Interval (CI) 2.4-8.0) with RA, in 11 (6.1%; 95% CI 2.6-9.5) with other
rheumatic diseases and in 12 patients (2.8%; 95% CI 1.2-4.4) with chronic non-
rheumatic diseases (NS). Low serum
PgA values were more frequent in older patients (P < 0.005) and females (P < 0.05). Pernicious anaemia occurred in RA in 1.2% (95% CI 0-2.6) of the patients while for other
rheumatic diseases the frequency was 1.7% (95% CI 0-3.5) and for chronic non-
rheumatic diseases 0.2% (95% CI 0-3.6) (NS). In patients with a serum
PgA below 17 micrograms/l, normal serum
gastrin levels (< 90 ng/l) as an indication of combined severe
atrophy of antrum and corpus, were found in 1/13 patients with RA, in 3/11 with other
rheumatic diseases and 2/12 with chronic non-
rheumatic diseases (NS). The frequency of low serum
PgA levels was no different between patients on
NSAIDs 17/355 (4.8%) and those without
NSAIDs 19/502 (3.8%).(ABSTRACT TRUNCATED AT 250 WORDS)