Prevalence of gastric parietal cell antibodies and intrinsic factor antibodies in primary biliary cirrhosis.

BACKGROUND: We investigated the prevalence of antibodies against gastric parietal cells (GPA), intrinsic factor antibodies (IFA) and the presence of pernicious anemia in a large cohort of primary biliary cirrhosis (PBC) patients as similar data is missing. METHODS: 157 PBC patients and 357 controls (73 with autoimmune hepatitis (AIH), 35 primary sclerosing cholangitis (PSC), 45 HBV, 37 HCV, 36 alcoholic liver disease (ALD), 35 non-alcoholic fatty liver disease (NAFLD) and 96 healthy) were investigated for IgG-isotype-specific GPA and IFA by ELISAs and vitamin-B(12) levels by a microparticle enzyme immunoassay. RESULTS: The detection of IgG-GPA was significantly higher in PBC (31.8%) compared to AIH (10.9%; p=0.001), PSC (0%; p=0.000), HCV (13.5%; p=0.01), HBV (13.3%; p=0.006), ALD (8.3%; p=0.004), NAFLD (11.4%; p=0.003) and healthy (10.4%; p=0.001). IgG-IFA were detected in 12% of GPA-positive PBC patients and in none of the other liver diseases or in healthy (p=0.001). This reactivity was significantly associated with lower vitamin-B(12) levels compared to those with an IFA-negative test (p=0.025). CONCLUSIONS: A significant proportion of PBC patients had IgG-GPA and IFA compared to controls. IgG-IFA were detected only in GPA-positive PBC patients and associated with lower vitamin-B(12) levels compared to those with an IFA-negative test.