Authors: Z El Ali M Fichna J Piniewska J Kosowicz M Grzymisławski
Publish Date: 2009/09/30
Volume: 33, Issue: 3, Pages: 186-191
Abstract
Background Antiparietal cells antibodies APCAb are commonly found in patients with autoimmune Addison’s disease AAD usually pointing to autoimmune atrophic gastritis and pernicious anemia The autoaggression to the gastric proton pump may result in a longterm hypergastrinemia which predisposes to enterochromaffinlike cell hyper/dysplasia and gastric carcinoids Aim We evaluated the clinical utility of assessing serum chromogranin A levels in patients with AAD Material and methods Serum chromogranin A gastrin and gastric APCAb levels were determined in 40 patients with AAD using commercially available kits Results Serum chromogranin A and gastrin levels were found to be elevated in 275 and 225 of patients with AAD respectively The Addison’s patients with elevated APCAb had significantly higher chromogranin A and gastrin levels as compared to individuals with normal APCAb chromogranin A 12800±12308 vs 5768±3650 ng/ml p=00036 gastrin 14138±19143 vs 4950±7536 ⧎U/ml p=0003 Additionally the patients with AAD and coexisting elevated serum APCAb contrary to those with normal levels showed a significant correlation between the chromogranin A and gastrin concentrations r=052 p=00092 vs r=0211 p=043 Serum chromogranin A appeared also significantly correlated with APCAb levels r=0431 p=0005 Conclusions In patients with autoimmune Addison’s disease hyperchromograninemia and hypergastrinemia occur with a prevalence of 275 and 225 respectively Addison’s patients with coexisting elevated gastric APCAb particularly with elevated gastrin levels are at risk of enterochromaffinlike cells hyper/dysplasia Serum chromogranin A assessment may complement histology for the early diagnosis of gastric carcinoid in these patients
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