Hematinic deficiencies and hyperhomocysteinemia in gastric parietal cell antibody-positive or gastric and thyroid autoantibodies-negative Behcet's disease patients

J Formos Med Assoc. 2019 Jan;118(1 Pt 2):347-353. doi: 10.1016/j.jfma.2018.05.017. Epub 2018 Jun 10.

Abstract

Background/purpose: Our previous study found that 9 of 63 recurrent aphthous stomatitis (RAS)/Behcet's disease (BD) patients have serum gastric parietal cell antibody (GPCA) positivity. This study assessed whether serum GPCA positivity or RAS/BD itself was a significant factor causing hematinic deficiencies and hyperhomocysteinemia in GPCA-positive RAS/BD (GPCA+RAS/BD) or gastric and thyroid autoantibodies-negative RAS/BD (Abs-RAS/BD) patients.

Methods: The mean blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine levels were measured and compared between any two of three groups of 9 GPCA+RAS/BD patients, 41 Abs-RAS/BD patients, and 126 healthy control subjects.

Results: GPCA+RAS/BD patients had significantly lower mean blood Hb (for men only), iron (for men only), and vitamin B12 levels as well as a significantly higher mean serum homocysteine level than 126 healthy control subjects. Moreover, GPCA+RAS/BD patients had significantly greater frequencies of blood Hb, iron, and vitamin B12 deficiencies and of hyperhomocysteinemia than healthy control subjects. GPCA+RAS/BD patients did have a significantly lower mean serum vitamin B12 level and a significantly higher mean serum homocysteine level as well as significantly greater frequencies of vitamin B12 deficiency and of hyperhomocysteinemia than Abs-RAS/BD patients. Moreover, Abs-RAS/BD patients did have significantly lower mean blood Hb, iron, and folic acid levels and significantly greater frequencies of blood Hb and iron deficiencies than healthy control subjects.

Conclusion: The GPCA is a major factor causing vitamin B12 deficiency and hyperhomocyteinemia in GPCA+RAS/BD patients. RAS/BD itself does play a significant role in causing anemia and hematinic deficiencies in both GPCA+RAS/BD and Abs-RAS/BD patients.

Keywords: Anemia; Behcet's disease; Gastric parietal cell antibody; Hyperhomo-cysteinemia; Iron deficiency; Vitamin B12 deficiency.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood*
  • Behcet Syndrome / blood*
  • Case-Control Studies
  • Female
  • Folic Acid / blood
  • Folic Acid Deficiency / blood
  • Hematinics
  • Hemoglobins / analysis
  • Humans
  • Hyperhomocysteinemia / blood*
  • Iron / blood
  • Male
  • Middle Aged
  • Parietal Cells, Gastric / immunology
  • Stomach / immunology
  • Stomatitis, Aphthous / blood*
  • Taiwan
  • Thyroid Gland / immunology
  • Vitamin B 12 / blood
  • Vitamin B 12 Deficiency / blood
  • Young Adult

Substances

  • Autoantibodies
  • Hematinics
  • Hemoglobins
  • Folic Acid
  • Iron
  • Vitamin B 12