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*Etiology: autoimmune. | *Etiology: autoimmune. | ||
Diagnosis based on serology for antibodies to:<ref name=pmid12643357>{{Cite journal | last1 = Oh | first1 = R. | last2 = Brown | first2 = DL. | title = Vitamin B12 deficiency. | journal = Am Fam Physician | volume = 67 | issue = 5 | pages = 979-86 | month = Mar | year = 2003 | doi = | PMID = 12643357 }}</ref> | Diagnosis based on serology for antibodies to:<ref name=pmid12643357>{{Cite journal | last1 = Oh | first1 = R. | last2 = Brown | first2 = DL. | title = Vitamin B12 deficiency. | journal = Am Fam Physician | volume = 67 | issue = 5 | pages = 979-86 | month = Mar | year = 2003 | doi = | PMID = 12643357 }}</ref><ref>{{cite journal |authors=Salinas M, Flores E, López-Garrigós M, Leiva-Salinas C |title=High frequency of anti-parietal cell antibody (APCA) and intrinsic factor blocking antibody (IFBA) in individuals with severe vitamin B12 deficiency - an observational study in primary care patients |journal=Clin Chem Lab Med |volume=58 |issue=3 |pages=424–429 |date=February 2020 |pmid=31714882 |doi=10.1515/cclm-2019-0749 |url=}}</ref> | ||
*Parietal cells. | *Parietal cells: anti-parietal cell antibody (APCA). | ||
*Intrinsic factor. | *Intrinsic factor: intrinsic factor blocking antibody (IFBA). | ||
Others: | Others: | ||
*Gastrin level (increased).<ref name=pmid21947876>{{Cite journal | last1 = Annibale | first1 = B. | last2 = Lahner | first2 = E. | last3 = Fave | first3 = GD. | title = Diagnosis and management of pernicious anemia. | journal = Curr Gastroenterol Rep | volume = 13 | issue = 6 | pages = 518-24 | month = Dec | year = 2011 | doi = 10.1007/s11894-011-0225-5 | PMID = 21947876 }}</ref> | *Gastrin level (increased).<ref name=pmid21947876>{{Cite journal | last1 = Annibale | first1 = B. | last2 = Lahner | first2 = E. | last3 = Fave | first3 = GD. | title = Diagnosis and management of pernicious anemia. | journal = Curr Gastroenterol Rep | volume = 13 | issue = 6 | pages = 518-24 | month = Dec | year = 2011 | doi = 10.1007/s11894-011-0225-5 | PMID = 21947876 }}</ref> | ||
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*[[Gastric neuroendocrine tumour]]. | *[[Gastric neuroendocrine tumour]]. | ||
*[[Intestinal metaplasia of the stomach]] with chronic inflammation. | *[[Intestinal metaplasia of the stomach]] with chronic inflammation. | ||
*[[Chronic gastritis]]. | |||
===Images=== | ===Images=== | ||
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===Images=== | ===Images=== | ||
====Body==== | |||
<gallery> | <gallery> | ||
Image: Metaplastic atrophic gastritis - body - chromogranin A -- very low mag.jpg | MAG (body) - chromogranin A - very low mag. | Image: Metaplastic atrophic gastritis - body - chromogranin A -- very low mag.jpg | MAG (body) - chromogranin A - very low mag. | ||
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Image: Metaplastic atrophic gastritis - body - gastrin -- low mag.jpg | MAG (body) - gastrin - low mag. | Image: Metaplastic atrophic gastritis - body - gastrin -- low mag.jpg | MAG (body) - gastrin - low mag. | ||
Image: Metaplastic atrophic gastritis - body - alt - gastrin -- low mag.jpg | MAG (body) - gastrin - low mag. | Image: Metaplastic atrophic gastritis - body - alt - gastrin -- low mag.jpg | MAG (body) - gastrin - low mag. | ||
</gallery> | |||
====Antrum==== | |||
<gallery> | |||
Image: Metaplastic atrophic gastritis - antrum - gastrin -- low mag.jpg | MAG (antrum) - gastrin - low mag. | Image: Metaplastic atrophic gastritis - antrum - gastrin -- low mag.jpg | MAG (antrum) - gastrin - low mag. | ||
Image: Metaplastic atrophic gastritis - antrum - gastrin -- intermed mag.jpg | MAG (antrum) - gastrin - intermed. mag. | Image: Metaplastic atrophic gastritis - antrum - gastrin -- intermed mag.jpg | MAG (antrum) - gastrin - intermed. mag. | ||
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==Sign out== | ==Sign out== | ||
<pre> | |||
Stomach, Body, Biopsy: | |||
- Gastric mucosa with INTESTINAL METAPLASIA, | |||
moderate chronic inactive inflammation and atrophic features, SEE COMMENT. | |||
- NEGATIVE for apparent parietal cells, SEE COMMENT. | |||
- NEGATIVE for Helicobacter-like organisms. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
Comment: | |||
Immunostains show rows of Chromogranin A positive cells and a lack of gastrin staining. | |||
These findings suggest an autoimmune (metaplastic atrophic) gastritis; correlation with blood work and clinical findings is recommended. | |||
</pre> | |||
====Listing the blood work==== | |||
<pre> | |||
If not already done, correlation with blood work (anti-parietal cell antibody, intrinsic factor blocking antibody, gastrin) and clinical findings is recommended. | |||
</pre> | |||
===Block letters=== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: |
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