Anti Parietal Cell Antibody

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Detects antibodies against stomach parietal cells.

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Anti-Parietal Cell Antibody Test Information Guide

Why is it done?
- Detects autoantibodies against parietal cells of the gastric mucosa that produce intrinsic factor and gastric acid
- Diagnose autoimmune gastritis and pernicious anemia (vitamin B12 deficiency)
- Evaluate patients with unexplained macrocytic anemia or elevated methylmalonic acid and homocysteine
- Investigate gastrointestinal symptoms including chronic diarrhea, abdominal pain, or food malabsorption
- Screen patients at risk for autoimmune conditions or those with family history of pernicious anemia
- Monitor progression of autoimmune gastritis or response to treatment
- Typically performed when patients present with neurological symptoms (peripheral neuropathy, paresthesia), fatigue, or cognitive changes associated with B12 deficiency
Normal Range
- Reference Range: Negative or <1.0 IU/mL (International Units per milliliter)
- Unit of Measurement: IU/mL or titre (if measured by immunofluorescence)
- Negative Result: Absence of anti-parietal cell antibodies; generally indicates no autoimmune gastritis
- Positive Result: Presence of detectable antibodies against parietal cells; indicates likelihood of autoimmune gastritis
- Weak Positive (1.0-2.0 IU/mL): Borderline result requiring clinical correlation and possible repeat testing
- Moderate to Strong Positive (>2.0 IU/mL): High likelihood of active autoimmune gastritis and pernicious anemia
- Sensitivity and Specificity: Approximately 50-60% sensitivity and 95-99% specificity for pernicious anemia diagnosis
Interpretation
- Positive Anti-Parietal Cell Antibody: Strongly suggestive of autoimmune gastritis type A, where the immune system attacks the parietal cells of the stomach lining; indicates loss of intrinsic factor production leading to vitamin B12 malabsorption
- Negative Anti-Parietal Cell Antibody: Does not exclude autoimmune gastritis or pernicious anemia; approximately 40-50% of patients with pernicious anemia test negative; B12 deficiency may have other causes such as dietary insufficiency, gastrectomy, or intrinsic factor antibodies
- Clinical Significance with Positive Results: Indicates chronic gastritis with atrophy and hypochlorhydria; increased risk of gastric adenocarcinoma and gastric carcinoid tumors; requirement for lifelong B12 supplementation (injections preferred)
- Factors Affecting Results: Recent B12 injections may not affect antibody levels; medications affecting absorption; concurrent autoimmune conditions (thyroid disease, type 1 diabetes) may influence results; disease duration and activity
- False Positives: May occur in autoimmune thyroid disease, Addison's disease, type 1 diabetes, myasthenia gravis, or other autoimmune conditions; not all positive results indicate clinically significant disease
- Interpretation Context: Results must be correlated with intrinsic factor antibody status, serum B12 levels, methylmalonic acid, homocysteine, complete blood count, and clinical symptoms for comprehensive diagnosis
Associated Organs
- Primary Organ System: Gastrointestinal system, specifically the stomach; parietal cells located in gastric glands of fundus and body of stomach
- Associated Diseases: Autoimmune (Type A) gastritis, pernicious anemia, atrophic gastritis with achlorhydria, chronic gastritis with hypergastrinemia
- Secondary Organ Involvement: Nervous system (peripheral neuropathy, subacute combined degeneration of spinal cord); hematologic system (megaloblastic anemia); cardiovascular system (elevated homocysteine increases thrombotic risk)
- Associated Complications: Gastric adenocarcinoma (increased risk 2-3 fold); gastric neuroendocrine tumors (carcinoid); chronic diarrhea and malabsorption; vitamin B12 deficiency with neuropsychiatric manifestations; increased risk of other autoimmune diseases
- Cofactors and Related Conditions: Type 1 diabetes mellitus, Graves' disease, Hashimoto's thyroiditis, celiac disease, Addison's disease, vitiligo, premature ovarian failure
Follow-up Tests
- Intrinsic Factor Antibody Test: Highly specific test (>98%) for pernicious anemia; should be performed concurrently or if anti-parietal cell antibody is positive
- Serum Vitamin B12 Level: Essential confirmatory test; normal range 200-900 pg/mL; values <200 pg/mL indicate deficiency
- Serum Folate Level: Needed to differentiate B12 deficiency from folate deficiency; B12 and folate work together in DNA synthesis
- Methylmalonic Acid and Homocysteine: Sensitive markers of B12 deficiency; elevated levels support diagnosis; useful in early/subclinical deficiency
- Complete Blood Count (CBC): Reveals macrocytic anemia (MCV >100 fL), hypersegmented neutrophils, thrombocytopenia; evaluate for megaloblastic changes
- Peripheral Blood Smear: Confirms megaloblastic morphology; demonstrates hypersegmented neutrophils, macro-ovalocytes
- Gastric Parietal Cell Antibody Panel (Comprehensive): May include H. pylori serology if autoimmune gastritis suspected
- Thyroid Peroxidase (TPO) and Thyroid Autoantibodies: Screen for concurrent autoimmune thyroid disease (frequently associated with autoimmune gastritis)
- Upper Endoscopy with Gastric Biopsy: May be indicated to assess severity of gastritis, rule out malignancy, evaluate for intestinal metaplasia, and monitor for gastric cancer development
- Serum Gastrin Level: Elevated in autoimmune gastritis due to loss of feedback inhibition; helps confirm diagnosis
- Monitoring Frequency: Annual B12 and CBC monitoring for treated patients; baseline endoscopy then every 3-5 years to screen for gastric malignancy; B12 injections typically administered monthly or quarterly long-term
Fasting Required?
- Fasting Required: No
- Food and Fluid Intake: No fasting restrictions; patient may eat and drink normally before blood draw
- Medications: No medications need to be held before test; ongoing B12 injections or oral supplements should not be discontinued before testing; proton pump inhibitors or H2 blockers do not interfere with antibody detection
- Special Preparation Instructions: Inform laboratory if patient has received blood transfusion or immunoglobulin therapy within 2-3 weeks; provide history of recent immunizations (may transiently affect antibody levels); notify technician of any recent systemic infections or autoimmune disease exacerbations
- Timing Considerations: Test can be performed at any time of day; morning or afternoon collection acceptable; no specific time-sensitive instructions required
- Sample Requirements: Blood sample collected in standard serum separator tube (SST); typical volume 5-7 mL; serum separated and refrigerated if not processed immediately

How our test process works!