Pernicious Anemia and Immunologic Deficiency

Abstract

The suggestion that serum gammaglobulin levels are commonly reduced in patients with pernicious anemia was not confirmed by immunoquantitation of serum immunoglobulins in 18 patients with pernicious anemia in relapse. Quantitation of immunoglobulins in 10 patients with roalabsorbtive disorders of diverse etiology did not show any instances of true hypogammaglobulinemia. Four of these patients exhibited increased serum IgA [immunoglobulin A] levels, a phenomenon previously reported only in gluten enteropathy. Although the anemia in these hypogammaglobulinemic patients was characteristic of pernicious anemia by hematologic and gastric criteria, they were usual in several ways. The average age of onset of the anemia was 30, unusually early for pericious anemia; none had parietal cell or intrinsic factor antibodies; Giardia laroblia was reported in 1/2 the patients with this combination of diseases. The concurrence of pernicious anemia and hypo-gammaglobulinemia is too frequent to be explained by coincidental occurence., Although the explanation of this relationship is not clear, the associations of hypogammaglobulinemia with malabsorbtion and malabsorbtion with gastric atrophy suggests that gastric atrophy may be a secondary consequence of hypogammaglobulinemia which usually preceeded the pernicious anemia. Further investigations are needed to clarify the pathogenesis of this syndrome.