title: A study of Helicobacter pylori infection in patients with pernicious anemia.
abstract: BACKGROUND
  Chronic atrophic gastritis presents with atrophy of the gastric mucosa, hypochlorhydria or achlorhydria and unstable gastrin level. Type A chronic atrophic gastritis associated with hypergastrinemia is regarded as the principle causative factor for pernicious anemia.
  
  
  OBJECTIVE
  The study aimed at evaluation of the incidence of H. pylori infection in patients with pernicious anemia and analyze its relation to the severity of gastritis.
  
  
  METHODS
  Forty patients with pernicious anemia (group 1) were examined for presence of H. pylori infection. Sex- and age-matched patients with gastric ulcer (group 2) and chronic superficial gastritis (group 3) were used as controls. Three antral forceps biopsies were obtained from all patients during videogastroscopy. The presence of H. pylori was verified by urease test, histological and microbiological examination.
  
  
  RESULTS
  All patients with pernicious anemia had chronic atrophic gastritis and several times lower incidence of H. pylori infection than the patients with gastric ulcer. Chronic atrophic gastritis was not diagnosed in group 3 patients. Statistically significant difference in Helicobacter pylori infection was found between groups 1 and 2 (P < 0.001) but not between groups 1 and 3 (P > 0.05).
  
  
  CONCLUSIONS
  Atrophic gastritis was diagnosed in all patients with pernicious anemia. These patients showed significantly lower incidence of H. pylori infection than the gastric ulcer patients. The patients with pernicious anemia had lower gastritis index and quantitatively less expressed infection than the other two groups.
authors.affiliation: Higher Medical Institute, Clinic of Gastroenterology, 15A Vassil Aprilov St., 4000 Plovdiv, Bulgaria.
authors.forename: V G
authors.initials: VG
authors.lastname: Djurkov
authors.forename: J G
authors.initials: JG
authors.lastname: Grudeva-Popova
authors.forename: I N
authors.initials: IN
authors.lastname: Houbavenska
mesh_terms: D000328:Adult; D000368:Aged; D000752:Anemia, Pernicious / Q000150:complications* / Q000209:etiology; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005757:Gastritis, Atrophic / Q000150:complications; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D013276:Stomach Ulcer / Q000150:complications