Graves' disease patients with iron deficiency anemia: serologic evidence of co-existent autoimmune gastritis.

American journal of blood research Pub Date : 2021-06-15 eCollection Date: 2021-01-01
Andrew G Gianoukakis, Shelly Gupta, Theresa N Tran, Patrick Richards, Marelle Yehuda, Sarah E Tomassetti
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Abstract

Background: Graves' disease (GD) has been associated with iron deficiency anemia (IDA). Atrophic gastritis leads to IDA and has been associated with autoimmune thyroid disease. This study prospectively determined the prevalence of atrophic gastritis markers and the relationship between these markers and markers of IDA in GD subjects.

Methods: Newly diagnosed GD patients (90) and controls (41) were studied. Of the newly diagnosed GD patients, 65 were consecutively enrolled and identified with GD irrespective of anemia, 25 had GD and IDA. Thyroid function, hematologic indices, and atrophic gastritis markers [parietal-cell antibodies (PCab), Helicobacter pylori antibodies (H. pylori ab), mean serum gastrin levels] were examined.

Results: GD patients presenting with IDA were twice as likely (64% vs. 32%, P=0.049) to harbor PCabs when compared to all other GD subjects. Unselected GD subjects (n=65) had significantly higher PCab (37% vs. 7%, P<0.001) compared to controls. Gastrin levels were significantly elevated in all GD subjects compared to controls (105 vs. 39 pg/ml, P<0.0001). This difference was magnified in PCab+ subjects (202 vs. 64 pg/ml, P=0.003). In all GD subjects, PCabs were associated with increased gastrin levels (202 vs. 75 pg/ml, P=0.0004) and lower ferritin levels (52 vs. 95, P=0.05). In GD anemic subjects, PCabs were associated with lower mean corpuscular volume (75 vs. 81, P=0.001). Gastrin levels correlated inversely with ferritin levels in all GD subjects and positively with TIBC in GD anemic subjects.

Conclusions: A significant subset of patients presenting with GD may suffer from IDA due to concurrent autoimmune atrophic gastritis.

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Graves病患者合并缺铁性贫血:自身免疫性胃炎共存的血清学证据
背景:Graves病(GD)与缺铁性贫血(IDA)相关。萎缩性胃炎可导致IDA并与自身免疫性甲状腺疾病相关。本研究前瞻性地确定了GD受试者中萎缩性胃炎标志物的患病率以及这些标志物与IDA标志物之间的关系。方法:新诊断GD患者90例,对照组41例。在新诊断的GD患者中,65例连续入组并确诊为GD,与贫血无关,25例同时患有GD和IDA。检测甲状腺功能、血液学指标和萎缩性胃炎标志物[壁细胞抗体(PCab)、幽门螺杆菌抗体(H. pylori ab)、平均血清胃泌素水平]。结果:与所有其他GD受试者相比,出现IDA的GD患者携带pcab的可能性是其两倍(64% vs. 32%, P=0.049)。未选择的GD受试者(n=65)的PCab显著升高(37% vs. 7%)。结论:出现GD的患者中有相当一部分可能由于并发自身免疫性萎缩性胃炎而患有IDA。
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American journal of blood research
American journal of blood research MEDICINE, RESEARCH & EXPERIMENTAL-
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