Pernicious Anaemia Society
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Can they only diagnosis PA through an intrinsic factor test or partial cell test? (however it is called)

I have seen two different GI's the first i saw two years ago said my ileum appeared normal on a colonscopy.My espophagus was normal. Erythematous mucosa without bleeding was found in gastric antrum. Bilious fluid found in gastric body. My duodenum was normal.but never did a h-pylori blood test to see if i had that or not (biospy didnt show any h-pylori on endoscopy)

I saw another GI in march of this year who said i still have mild gastritis and a hiatus hernia in the esophagus/ and duodenitis was found in the duodenal bulb.

I had alot of symptoms prior to having gastritis or any of the other stomach issues. But i was always diagnosed with anxiety.

2 Replies

Examination of the terminal ileum won't tell them anything at all about PA. PA is an autoimmune disease of the stomach whereby certain cells are attacked by the body's own defenses and destroyed. One of the things these cells does is produce Intrinsic Factor - a protein that escorts B12 molecules across the gut wall.

So IF binds with B12 in the stomach and the complex moves through the gut to the ileum, where receptors grab hold of the IF and drag it across the intestinal wall, carrying the B12 with it.

The autoimmune attack causes something called Autoimmune Metaplastic Gastric Atrophy - which can be diagnosed by a combination of several things -

Autoimmune - Tests for two antibodies - anti-IF and anti-GPC (Gastric Parietal Cells) can determine if it's autoimmune. A positive for anti-IF means it's 96% certain to be PA. A negative doesn't rule out PA. A positive for anti-GPC means it's probably PA. A negative means it probably isn't.

Metaplastic - Microscopic examination of small tissue samples (biopsies) taken during a gastroscopy will show signs of the GPCs being replaced by other types of cells.

Gastric Atrophy - AKA Atrophic Gastritis, should be obvious from a visual examination of the stomach during a gastroscopy.


Okay thank you! So i do neef to get the other test done to know for sure?


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