Letters To The Editor
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World J Gastroenterol. Jan 28, 2011; 17(4): 543-544
Published online Jan 28, 2011. doi: 10.3748/wjg.v17.i4.543
Pernicious anemia: What are the actual diagnosis criteria?
Daniel Cattan
Daniel Cattan, Department of Internal Medicine and Hepato-Gastroenterology, Centre Hospitalier, 94195 Villeneuve Saint George, France
Author contributions: Cattan D contributed to all of this letter.
Correspondence to: Daniel Cattan, Professor, Department of Internal Medicine and Hepato-Gastroenterology, Centre Hospitalier, 94195 Villeneuve Saint George, France. danielcattan@yahoo.fr
Telephone: +33-1-60470829 Fax: +33-1-43310249
Received: October 21, 2010
Revised: December 1, 2010
Accepted: December 8, 2010
Published online: January 28, 2011
Abstract

A gastric intrinsic factor output under 200 U/h after pentagastrin stimulation (N > 2000 U/h) is specific for pernicious anemia. The other findings are either variable or non specific. Serum intrinsic factor antibodies, considered as specific in general practice, are present only in half of the patients with pernicious anemia. In their absence, since the disappearance of the Schilling tests, the gastric tubage currently used for the study of gastric acid secretion, is obligatory for the simultaneous study of intrinsic factor output. This study is important to eliminate another disease much more frequent than pernicious anemia, the protein bound to cobalamin malabsorption was observed in achlorhydric simple atrophic gastritis in the presence of intrinsic factor secretion.

Keywords: Pernicious anemia, Intrinsic factor, Achlorhydria, Schilling test, Helicobacter pylori