Pernicious anemia (PA) is an autoimmune disease that occurs as an end stage of
autoimmune gastritis which results in the destruction of gastric mucosa (moist tissue that
lines the stomach). It follows long-term autoimmune gastritis (inflammation of the
mucosal lining of the stomach). The autoimmune process is limited to the body of the
stomach and causes gastric atrophy (wasting of tissue).
The auto-reaction is against the gastric intrinsic factor (substance that makes the
absorption of vitamin B-12 possible) and complement-fixing antibodies to gastric parietal
cells (the binding site for vitamin B-12). Long-term destruction of the parietal cells of the
gastric mucosa results in atrophy leading to the inability of the stomach to absorb and
utilize vitamin B-12. Thus, PA is the end result of autoimmune gastritis. The gastric
atrophy is caused by chronic inflammation from the autoimmune attack on the lining of the
stomach and precedes the development of PA by many years. PA has been observed to
cluster in families.
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