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Case Rep Hematol 2022 21;2022:6423143. Epub 2022 Apr 21.

HCA HealthONE, Lone Tree, CO, USA.

Herein, we present a unique case of a Coombs-negative, steroid-refractory autoimmune hemolytic anemia (AIHA) complicated by pseudoreticulopenia, describe its clinical presentation, histopathologic findings, and management, and review the salient literature. Coombs-negative, steroid-refractory AIHAs represent fewer than 1% of all AIHAs. Diagnosis of the disease is difficult and often delayed due to the pursuit of alternate diagnoses following a negative Coombs test. Read More

Front Immunol 2022 11;13:887256. Epub 2022 Apr 11.

Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.

Pernicious anemia (PA) is a megaloblastic anemia consisting of hematological, gastric and immunological alterations. The immunopathogenesis of PA is sustained by both autoantibodies (e.g. Read More

Transl Res 2022 Apr 22. Epub 2022 Apr 22.

Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, University Sapienza, Rome, Italy.

Gender-sex differences in autoimmune diseases are gaining increasing attention due to their effects on prevalence and clinical features. Data on gender-sex differences in autoimmune atrophic gastritis (AAG), a chronic not-self-limiting inflammatory condition characterized by corpus-oxyntic mucosa atrophy sparing the antrum, are lacking. This study aimed to assess possible gender-sex differences of clinical, serological, histological, and genetic features in AAG patients. Read More

J Allergy Clin Immunol 2022 Apr 22. Epub 2022 Apr 22.

Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, United Kingdom. Electronic address:

Background: Atopic dermatitis (AD) is associated with immune dysregulation, but epidemiologic data on the pattern of autoimmune comorbidity in people with AD are limited.

Objective: We sought to determine the risk of autoimmune conditions in people newly diagnosed with AD.

Methods: Retrospective cohort analysis (January 2009 to December 2018), using the UK-based Oxford-Royal College of General Practitioners Research and Surveillance Centre primary care database. Read More

Nutrients 2022 Apr 17;14(8). Epub 2022 Apr 17.

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, University Sapienza, 00189 Rome, Italy.

Pernicious anemia is still a neglected disorder in many medical contexts and is underdiagnosed in many patients. Pernicious anemia is linked to but different from autoimmune gastritis. Pernicious anemia occurs in a later stage of autoimmune atrophic gastritis when gastric intrinsic factor deficiency and consequent vitamin B deficiency may occur. Read More

Int J Mol Sci 2022 Apr 10;23(8). Epub 2022 Apr 10.

Department of Biochemistry and Biotechnology, University of Life Sciences, 60-632 Poznań, Poland.

Dysregulation of one-carbon metabolism affects a wide range of biological processes and is associated with a number of diseases, including cardiovascular disease, dementia, neural tube defects, and cancer. Accumulating evidence suggests that one-carbon metabolism plays an important role in COVID-19. The symptoms of long COVID-19 are similar to those presented by subjects suffering from vitamin B deficiency (pernicious anemia). Read More

Acta Biochim Pol 2022 Apr 22. Epub 2022 Apr 22.

Faculty of Medicine, Centre for Innovative Research in Medical and Natural Sciences, University of Rzeszów, Rzeszów Poland.

Based on current scientific reports, vitamin B12 (cobalamin), used in the treatment of pernicious anemia, may be used as a pain reliever. It has been shown to be effective in the treatment of different sorts of pain, including diabetic neuropathic, musculoskeletal, abdominal, back and spine ones, but also pain in Alzheimer's disease and pain ailments resulting from the development of neoplasms. In addition, it helps regeneration of the sensory nerves and relieves pain in eye diseases, for example in dry eye syndrome. Read More

Case Rep Hematol 2022 11;2022:2854520. Epub 2022 Apr 11.

St. Joseph's University Medical Center, 703 Main St., Paterson, NJ 07503, USA.

Splenomegaly is manifested by a variety of etiologies, one of which is macrocytic anemia. Macrocytic anemia has multiple causes in itself that include; folate (Vitamin B9) and Cobalamin (vitamin B12) deficiencies. In this case report, we present a patient with a history of pancytopenia, macrocytic anemia and vitamin B12 deficiency, who underwent a splenectomy. Read More

Cureus 2022 Mar 14;14(3):e23152. Epub 2022 Mar 14.

Internal Medicine, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT.

Macrocytosis is defined as a mean corpuscular volume greater than 100 femtolitres (fL). There are several causes for macrocytic anaemia, and they can be divided into megaloblastic or non-megaloblastic anaemia. Vitamin B12 deficiency is one of the most common causes of megaloblastic anaemia. Read More

Dtsch Med Wochenschr 2022 04 11;147(8):451-459. Epub 2022 Apr 11.

Autoimmune gastritis (AIG) is a chronic immune-mediated inflammation of the gastric corpus/fundus mucosa leading to progressive atrophy of the oxyntic gastric glands (AOM) and their consecutive loss of function. Possible clinical consequences of AIG include iron deficiency anemia, pernicious anemia, gastric neuroendocrine tumors (gNET), and gastric adenocarcinoma. This article provides a review of interdisciplinary aspects of the diagnosis and treatment of AIG. Read More

Am J Trop Med Hyg 2022 Apr 11. Epub 2022 Apr 11.

Infectious Disease-Service, Tripler Army Medical Center, Honolulu, Hawaii.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated pancytopenia is a known but rare complication of COVID-19 syndrome that is not well described in literature. Severe acute respiratory syndrome coronavirus 2 has shown the potential to affect any organ including the bone marrow, which then results in a decrease in all three blood cell lines. These cases usually resolve with the passage of time and treatment of underlying risk factors. Read More

Case Rep Endocrinol 2022 18;2022:9363543. Epub 2022 Mar 18.

Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy.

Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease in which destruction of the insulin-producing -cells in the pancreatic islets requires regular lifelong insulin replacement therapy, the only lifesaving treatment available at this time. In young persons with a genetic predisposition, it usually manifests after being exposed to environmental triggers. A subtype of autoimmune diabetes mellitus (ADM) that typically occurs in adulthood is often referred to as latent autoimmune diabetes of adults (LADA). Read More

Clin Med Insights Endocrinol Diabetes 2022 22;15:11795514221086634. Epub 2022 Mar 22.

Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt.

Background: B12 (cobalamin) deficiency has been reported in hypothyroid patients with variable prevalence rates thus routine screening of hypothyroid patients was recommended by some and discouraged by others. We aimed to assess the prevalence of B12 deficiency among hypothyroid patients and to evaluate for pernicious anemia and celiac disease as etiologies.

Methods: A total 133 patients were included. Read More

Vitam Horm 2022 11;119:405-439. Epub 2022 Mar 11.

Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, United States.

Of the water-soluble vitamins, vitamin B12 (B12) has the lowest daily requirement. It also has several unique properties including a complex pathway for its absorption and assimilation requiring intact gastric and terminal small intestinal function, an enterohepatic pathway, and several dedicated binding proteins and chaperons. The many causes of B12 deficiency include malabsorption and defects in cellular delivery and uptake, as well as limited dietary intake. Read More

Vitam Horm 2022 1;119:241-274. Epub 2022 Mar 1.

Department of Internal Medicine, Division of Gastroenterology, Washington University School of Medicine, St Louis, MO, United States. Electronic address:

Vitamin B12 is assimilated and transported by complex mechanisms that involve three transport proteins, intrinsic factor (IF), haptocorrin (HC) and transcobalamin (TC) and their respective membrane receptors. Vitamin deficiency is mainly due to inadequate dietary intake in vegans, and B12 malabsorption is related to digestive diseases. This review explores the physiology of vitamin B12 absorption and the mechanisms and diseases that produce malabsorption. Read More

Vaccines (Basel) 2022 Mar 15;10(3). Epub 2022 Mar 15.

Center for Biologics Evaluation and Research (CBER), Division of Viral Products, Food and Drug Administration (FDA), Silver Spring, MD 20993, USA.

In healthy adults, hybrid immunity induced by prior SARS-CoV-2 infection followed by two doses of mRNA vaccination provide protection against symptomatic SARS-CoV-2 infection. However, the role of hybrid immunity in autoimmune patients against Omicron is not well documented. Here, we report a young autoimmune patient with prior infection and two doses of mRNA-1273 vaccination who was exposed to Omicron and developed a symptomatic disease. Read More

Hum Mol Genet 2022 Feb 28. Epub 2022 Feb 28.

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Autoimmune thyroid disease (AITD) and pernicious anemia (PA) often coexist, but the directionality is unknown. In a two-sample Mendelian randomization (MR) analysis, using summary statistics from large genome-wide association studies in Europeans (N = 49 269-755 406), we examined the genetic associations between thyroid function, pernicious anemia and markers of erythropoiesis. We performed inverse variance weighted random-effects MR, several sensitivity MR analyses, and bidirectional MR and MR Steiger for directionality. Read More

Cureus 2022 Jan 21;14(1):e21476. Epub 2022 Jan 21.

Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Vitamin B12 is an essential vitamin. Among its many functions is its crucial role as a coenzyme in a step of normal synthesis of myelin. Likewise, it is a vital coenzyme in the synthesis of neurotransmitters. Read More

Anticancer Res 2022 Mar;42(3):1517-1526

Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil

Background/aim: To estimate the prevalence of autoimmune atrophic gastritis (AAG) in the Russian Federation, a systematic screening of asymptomatic healthy adults by non-invasive biomarker testing was conducted. The aim was i) To test the validity of non-invasive serological screening for AAG; ii) to establish the prevalence of AAG among asymptomatic adults.

Patients And Methods: Altogether, 1,283 asymptomatic, healthy adults (mean age: 38 years) were screened by GastroPanel test. Read More

Hormones (Athens) 2022 Feb 19. Epub 2022 Feb 19.

Faculty of Health and Medical Research, Copenhagen University, Copenhagen, Denmark.

Background: Autoimmune disease, including autoimmune thyroid disease, with uncharacteristic symptoms can be due to additional severe disease. We report a life-threatening debut of autoimmune polyglandular syndrome type II (APS II) defined as Addison's disease combined with autoimmune diabetes and/or thyroid disease.

Patient Findings: A 33-year-old male with newly diagnosed hypothyroidism was referred to a tertiary center due to fatigue and 20-kg rapid weight loss. Read More

Clin Case Rep 2022 Feb 4;10(2):e05391. Epub 2022 Feb 4.

Division of Hospital Internal Medicine Department of Internal Medicine Mayo Clinic College of Medicine and Science Scottsdale Arizona USA.

Autoimmune polyglandular syndromes (APS) are rare disorders characterized by auto-destruction of endocrine and non-endocrine organs by organ-specific antibody-directed T-lymphocytic infiltration. This case highlights a 29-year-old Caucasian man with vitiligo found to have significant neurological abnormalities in the setting of newly diagnosed pernicious anemia and thyroid autoimmune disease. Read More

BMJ Case Rep 2022 Feb 7;15(2). Epub 2022 Feb 7.

Mayo Clinic Hospital, Jacksonville, Florida, USA.

Stiff-person syndrome (SPS) is a rare, autoimmune, neurological disorder that often occurs concurrently with other autoimmune disorders, such as type 1 diabetes mellitus, pernicious anaemia, vitiligo and Hashimoto's thyroiditis. It also can manifest as a paraneoplastic syndrome. Although SPS classically presents with truncal and appendicular stiffness and lumbar hyperlordosis, it can present focally in a single limb (termed ). Read More

Case Rep Hematol 2022 29;2022:2036460. Epub 2022 Jan 29.

Indiana University Health Central Indiana Cancer Center, Indianapolis, IN, USA.

By this time, multiple vaccines have been approved to limit the spread of SARS-CoV-2 worldwide. These include new-generation vaccines that contain mRNA of the target organism. Some common side effects were identified and reported during phase 3 clinical trials of vaccination, but more rare adverse events were reported in the literature. Read More

Pediatr Int 2022 Jan;64(1):e14960

Division of Pediatric Hematology and Oncology, Ibaraki Children's Hospital, Mito, Japan.

Medicine (Baltimore) 2022 Jan;101(2):e28550

Pathology Department, University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania.

Rationale: Gastric neuroendocrine neoplasms (g-NENs) represent a distinctive group of gastric tumors, stratified into different prognostic categories according to different histological characteristics, put forth in the 2018 World Health Organization classification system. The clinical presentations, as well as pathological features, represent important data in establishing the type of the tumor, in estimating the tumor behavior, and in selecting the best therapeutic strategy. In our case series we presented different clinical scenarios that may be encountered in practice regarding gastric NENs. Read More

Am J Gastroenterol 2022 03;117(3):486-490

Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.

Introduction: Pernicious anemia (PA) is a risk factor for gastric cancer. Other autoimmune conditions may also contribute.

Methods: In a case-control study, we evaluated 47 autoimmune conditions among 39,125 gastric cancers and 200,000 cancer-free controls. Read More

J Transl Autoimmun 2021 1;4:100131. Epub 2021 Nov 1.

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant'Andrea Hospital, School of Medicine, University Sapienza, Rome, Italy.

Background: Corpus atrophic gastritis (CAG) may lead to intrinsic factor (IF) deficiency and vitamin B malabsorption. Intrinsic factor autoantibodies (IFA) are considered markers of pernicious anemia, but their clinical utility in CAG has not been evaluated. This study aimed to assess IFA in CAG patients and controls using a luciferase immunoprecipitation system (LIPS). Read More

Cureus 2021 Dec 7;13(12):e20228. Epub 2021 Dec 7.

Hematology Oncology, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York City, USA.

Hemolytic anemia with thrombocytopenia and organ damage raises suspicion for thrombotic microangiopathy (TMA), a pathology that results in thrombosis within the small vessels secondary to endothelial injury. While usually attributed to atypical hemolytic uremic syndrome (aHUS) or thrombotic thrombocytopenic purpura (TTP), an increasingly recognized and treatable entity is pseudo-thrombotic microangiopathic anemia (pseudo-TMA) secondary to severe vitamin B-12 deficiency. While TMA often requires expensive diagnostic testing and can lead to invasive treatment options such as plasma exchange, immunosuppression, and/or complement cascade blocking, pseudo-TMA requires only vitamin supplementation. Read More

Rom J Intern Med 2021 Dec 23. Epub 2021 Dec 23.

Department of Neurology, Institute of Human Behaviour and Allied Sciences, Dilshad Garden, Delhi, India, PIN-110095.

Introduction - Autoimmune polyglandular syndrome (APS) is a condition having multiple endocrine abnormalities. It is divided into three types depending on the involvement of various endocrinopathies. It is also associated with other systemic involvement. Read More

Front Cell Dev Biol 2021 26;9:752346. Epub 2021 Nov 26.

Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, St. Louis, MO, United States.

Gastric cancer is a leading cause of mortality worldwide. The risk of developing gastric adenocarcinoma, which comprises >90% of gastric cancers, is multifactorial, but most associated with infection. Autoimmune gastritis is a chronic autoinflammatory syndrome where self-reactive immune cells are activated by gastric epithelial cell autoantigens. Read More