Pernicious anemia and Helicobacter pylori infection in Japan: evaluation in a country with a high prevalence of infection

Am J Gastroenterol. 1995 Jul;90(7):1107-10.


Objectives: To evaluate the degree of gastritis and the prevalence of Helicobacter pylori in Japanese patients with pernicious anemia (PA).

Methods: Histological assessment for mucosal atrophy and inflammation was performed in gastric biopsy specimens taken from 24 Japanese patients with PA and from 24 age- and sex-matched controls. The prevalence of H. pylori was evaluated by Giemsa staining and serum IgG antibodies. Serum gastrin and pepsinogens were determined by radioimmunoassay.

Results: All patients with PA had severe fundic atrophic gastritis, and 17 (71%) also had antral atrophic gastritis. Thirteen (54%) of 24 age- and sex-matched controls had fundic atrophic gastritis, and 15 (62%) also had antral atrophic gastritis. Mucosal inflammation was identified in the fundus of all 24 patients and in 15 (62%) controls and in the antrum of 22 (92%) patients and 16 (67%) controls. H. pylori was not detected by Giemsa staining or serum IgG antibodies to H. pylori in any patient with PA but was present in 16 (67%) controls. Serum gastrin levels were significantly higher, and serum pepsinogen I, II, and the I/II ratio were significantly lower in patients than in controls (p < 0.001).

Conclusions: Our results confirm that H. pylori infection is infrequent in PA and is unlikely to be a factor in producing type A gastritis in PA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Pernicious / complications*
  • Female
  • Gastric Mucosa / pathology
  • Gastritis, Atrophic / etiology
  • Gastritis, Atrophic / pathology
  • Helicobacter Infections / complications*
  • Helicobacter Infections / epidemiology
  • Helicobacter Infections / pathology
  • Helicobacter pylori*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged