title: Chronic proton pump inhibition therapy in the diagnostic accuracy of serum pepsinogen I and gastrin concentrations to identify pernicious anaemia.
abstract: BACKGROUND
  Chronic use of proton pump inhibitors (PPIs) leads to increases in gastrin and pepsinogen-I serum concentrations.
  
  
  OBJECTIVE
  To asses if chronic treatment with PPIs has an effect on serum gastrin and pepsinogen-I concentrations for the diagnosis of pernicious anaemia (PA).
  
  
  METHODS
  Serum gastrin and pepsinogen-I were measured in 38 patients with PA and 74 without PA (controls); 17/38 PA patients and 36/74 controls were treated with PPIs. Receiver Operating Curves (ROC) were used to compare diagnostic accuracy of gastrin and pepsinogen-I for PA in patients under chronic treatment with PPIs and in untreated patients.
  
  
  RESULTS
  PPI treatment increased pepsinogen-I in patients and in controls, while gastrin increased only in controls. In untreated patients, a pepsinogen-I <8.3ng/mL had 95.2% sensitivity and 100% specificity, whereas a gastrin >115pg/mL had 100% sensitivity and 92.11% specificity for PA diagnosis. In PPI-treated patients, a pepsinogen I<24.1ng/mL had a lower sensitivity (82.4%) but retained 100% specificity, however the best cut-off point for gastrin, 610pg/mL, had a very low sensitivity (58%).
  
  
  CONCLUSIONS
  PPI chronic treatment decreased the diagnostic accuracy for the studied biomarkers, particularly of gastrin. In PPI-treated patients, serum pepsinogen-I concentrations >24.1ng/mL allowed rejecting a PA diagnosis with 100% specificity.
authors.affiliation: Department of Clinical Biochemistry, Hospital "Germans Trias i Pujol", Universitat Autonoma of Barcelona, Ctra Canyet s/n., 08916 Badalona, Barcelona, Spain.
authors.forename: Mariam
authors.initials: M
authors.lastname: Martín-Alcolea
authors.affiliation: Haematology-Laboratory, Hospital "Germans Trias i Pujol", Universitat Autonoma of Barcelona, Ctra Canyet s/n., 08916 Badalona, Barcelona, Spain.
authors.forename: Inés
authors.initials: I
authors.lastname: Rodríguez-Hernández
authors.affiliation: Department of Clinical Biochemistry, Hospital "Germans Trias i Pujol", Universitat Autonoma of Barcelona, Ctra Canyet s/n., 08916 Badalona, Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Aldea
authors.affiliation: Department of Clinical Biochemistry, Hospital "Germans Trias i Pujol", Universitat Autonoma of Barcelona, Ctra Canyet s/n., 08916 Badalona, Barcelona, Spain.
authors.forename: Irene
authors.initials: I
authors.lastname: Rosas
authors.affiliation: Haematology-Laboratory, Hospital "Germans Trias i Pujol", Universitat Autonoma of Barcelona, Ctra Canyet s/n., 08916 Badalona, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Juncà
authors.affiliation: Department of Clinical Biochemistry, Hospital "Germans Trias i Pujol", Universitat Autonoma of Barcelona, Ctra Canyet s/n., 08916 Badalona, Barcelona, Spain. Electronic address: mgranada.germanstrias@gencat.cat.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Granada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000752:Anemia, Pernicious / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005755:Gastrins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D005755:Gastrins; D054328:Proton Pump Inhibitors; D020116:Pepsinogen A
keywords: Autoimmune gastritis; Biomarkers; Gastrin; Pepsinogen-I; Pernicious anaemia; Proton pump inhibitors