Idiopathic Hypochromic Anemia

Wintrobe, M. M.; Beebe, Richard T.

doi:10.1097/00005792-193305000-00002

Cited by 60 publications

(17 citation statements)

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“…Likewise, the seminal observations of Faber and Bloch 26 on gastric atrophy involving the proximal two thirds of the stomach are recognized not only as a major insight into the pathogenesis of PA, but also as a characteristic feature of achylia gastrica, a syndrome of chronic IDA associated with gastric atrophy first described by the same author in 1909 27 and recognized subsequently as a major cause of IDA. 28,29 Achylia gastrica was largely forgotten and completely ignored in subsequent major surveys of gastrointestinal causes of IDA. 30,31 More recently, achlorhydric gastric atrophy has been rediscovered by Dickey et al 32 and implicated in 20% of patients with IDA with no evidence of gastrointestinal blood loss.…”

Section: Discussionmentioning

confidence: 99%

Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion

Hershko

Ronson

Souroujon

et al. 2006

Blood

201

141

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Section: Discussionmentioning

confidence: 99%

Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion

Hershko

Ronson

Souroujon

et al. 2006

Blood

201

141

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“…Recent observations indicating that genetic variability of host factors, as well as the composition of ironrepressible outer membrane proteins of H pylori, may determine the clinical expression of disease may represent important new insights into the mechanism and severity of H pylori infection. 38,39 Autoimmune atrophic gastritis Achylia gastrica as a cause of IDA has first been described as a clinical entity by Faber in 1909 40 ; achlorhydric gastric atrophy, a synonym for the same entity, has long been recognized as a major cause of IDA 41 but has been completely ignored in subsequent major surveys of gastrointestinal causes of IDA. More recently, achlorhydric gastric atrophy was rediscovered by Dickey et al, 14 and implicated in 20% of IDA patients with no evidence of gastrointestinal blood loss.…”

Section: H Pylori Gastritismentioning

confidence: 99%

How I treat unexplained refractory iron deficiency anemia

Hershko

Camaschella

2014

Blood

140

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Endoscopic gastrointestinal workup fails to establish the cause of iron deficiency anemia (IDA) in a substantial proportion of patients. In patients referred for hematologic evaluation with unexplained or refractory IDA, screening for celiac disease, autoimmune gastritis, Helicobacter pylori, and hereditary forms of IDA is recommended. About 4% to 6% of patients with obscure refractory IDA have celiac disease, and autoimmune gastritis is encountered in 20% to 27% of patients. Stratification by age cohorts in autoimmune gastritis implies a disease presenting as IDA many years before the establishment of clinical cobalamin deficiency. Over 50% of patients with unexplained refractory IDA have active H pylori infection and, after excluding all other causes of IDA, 64% to 75% of such patients are permanently cured by H pylori eradication. In young patients with a history suggestive of hereditary iron deficiency with serum ferritin higher than expected for IDA, mutations involving iron trafficking and regulation should be considered. Recognition of the respective roles of H pylori, autoimmune gastritis, celiac disease, and genetic defects in the pathogenesis of iron deficiency should have a strong impact on the current diagnostic workup and management of unexplained, or refractory, IDA.

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“…It is also important to compare separately the results in patients whose initial hemoglobin values were below and above 50 per cent. In our series, pa- (15) and occasionally rather small doses of iron will cause surprising improvement (20).…”

Section: Discussionmentioning

confidence: 50%