Pepsinogens and other serum markers in pernicious anemia.
Pepsinogen (PG) I and PG II levels were determined in sera from 147 patients with pernicious anemia. Race, sex, age, gastrin level, and antibody status did not influence pepsinogen levels. PG I values less than 30 micrograms/L were found in 92% of cases and PG I to PG II ratios less than 3.0 in 82% of cases. At least one of these two results was abnormal in 97% of all patients with pernicious anemia. In comparison, results of other blood tests used in the investigation of pernicious anemia were less often abnormal. Serum gastrin level exceeded 200 ng/L in 90% of patients with pernicious anemia and was second to pepsinogen abnormality in diagnostic sensitivity. Results for anti-intrinsic factor antibody were positive in 73% of cases and anti-parietal cell antibody in only 52%. Although its specificity is limited, the presence of low PG I level and/or low PG I-PG II ratio is currently the most sensitive serum indicator for pernicious anemia, and absence of both can be taken as a strong argument against the diagnosis. This highly sensitive test can be combined further with the highly specific serum anti-intrinsic factor antibody test for the presumptive diagnosis of pernicious anemia when definitive tests (the Schilling test or gastric analysis for intrinsic factor) cannot be done or results are inconclusive.
Carmel
R
R
Department of Medicine, Los Angeles County-USC Medical Center, California 90033.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000752:Anemia, Pernicious / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D001323:Autoantibodies / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D002648:Child; D005260:Female; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood*
D001323:Autoantibodies; D015415:Biomarkers; D005755:Gastrins; D010435:Pepsinogens