A 62-year-old woman has macrocytic anemia, neurological paresthesias, and atrophic glossitis. Gastric biopsy shows atrophic body fundus mucosa with lymphoid infiltrate. Which autoantibody profile best fits autoimmune gastritis with pernicious anemia?

• A Anti-intrinsic factor antibody highly sensitive, anti-parietal cell antibody highly specific
• B Anti-parietal cell antibody highly sensitive, anti-intrinsic factor antibody highly specific ✓
• C Anti-gastric H,K-ATPase antibody exclusively specific for the disease
• D Anti-Helicobacter pylori IgG antibodies confirming the autoimmune etiology

Explanation

Autoimmune gastritis produces anti-parietal cell antibodies targeting the gastric H,K-ATPase, which are highly sensitive (present in up to 90 percent) but also occur in other autoimmune diseases and older adults, limiting specificity. Anti-intrinsic factor antibodies are less sensitive but highly specific for pernicious anemia. Helicobacter-associated gastritis causes an environmental metaplastic atrophic gastritis affecting the antrum predominantly, not the autoimmune corpus-restricted pattern described.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.