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Anti-gastric parietal cell antibodies for autoimmune gastritis screening in juvenile autoimmune thyroid disease

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Abstract

Objective

Patients with autoimmune thyroid disease (ATD) have a higher prevalence of autoimmune gastritis (AIG) compared with the general population. The association between ATD and AIG is poorly characterized in the pediatric age. We reviewed the prevalence of anti-gastric parietal cell antibodies (PCA) in young patients with ATD to evaluate its usefulness as a marker for AIG screening.

Methods

We evaluated 220 children and adolescents (11.28 ± 6.37 years) with ATD (186 with autoimmune thyroiditis (AT) and 34 with Graves’ disease (GD). At ATD diagnosis and annually thereafter, blood counts and PCA levels were measured. In patients positive for PCA, plasma gastrin, chromogranin A, vitamin B12, iron and ferritin levels and H. pylori antigen were measured. PCA-positive patients > 18 years were invited to undergo a gastroscopic exam.

Results

PCA positivity was detected in ten (4.5%) subjects (5F/5M; 12.6 ± 3.4 years). The prevalence of PCA positivity was not significantly different in the comparison of GD and AT patients (p = 0.9). PCA positivity was detected after 2.7 ± 2.7 years of follow-up in AT and 4.4 ± 4.0 years in GD (p = 0.4). Autoantibody positivity was more prevalent in female patients, in both AT and GD (p = 0.02 and p = 0.03, respectively). At detection of PCA positivity, five out of ten PCA-positive patients had iron deficiency, four vitamin B12 deficiency, two anemia, three hypergastrinemia and two elevated chromogranin values. Two patients had H. pylori infection. Gastroscopy was performed in the five ATD patients and in all patients, AIG was confirmed.

Conclusion

In the juvenile population, ATD and AIG may also be associated. PCA screening is useful to detect subjects at risk for this condition. Due to the longer life expectancy of the pediatric population and considering the relatively high risk of malignant transformation, early surveillance monitoring is mandatory for children and adolescents with ATD.

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Acknowledgements

The authors thank Dr. L. Kelly for English revision of the manuscript.

Funding

This research did not receive any funding from public, commercial, or non-profit agencies.

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Authors and Affiliations

  1. Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, Pavia, Italy

    V. Calcaterra, C. Montalbano, F. Vinci, C. Regalbuto & D. Larizza

  2. Pediatric Endocrinology Unit, Department of Maternal and Children’s Health, Fondazione IRCCS Policlinico San Matteo, P.le Golgi n.2, 27100, Pavia, Italy

    V. Calcaterra, C. Montalbano, F. Vinci, C. Regalbuto & D. Larizza

  3. First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    E. Miceli

  4. University of Pavia, Pavia, Italy

    E. Miceli

  5. Department of Molecular Medicine, University of Pavia, Pavia, Italy

    O. Luinetti

  6. Pathology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    O. Luinetti

  7. Laboratory of Clinical Chemistry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    R. Albertini

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  1. V. Calcaterra
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Correspondence to V. Calcaterra.

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This study was approved by the San Matteo Institutional Review Board and conducted according to the Declaration of Helsinki.

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Calcaterra, V., Montalbano, C., Miceli, E. et al. Anti-gastric parietal cell antibodies for autoimmune gastritis screening in juvenile autoimmune thyroid disease. J Endocrinol Invest 43, 81–86 (2020). https://doi.org/10.1007/s40618-019-01081-y

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  • DOI: https://doi.org/10.1007/s40618-019-01081-y

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