Elsevier

The Lancet

Volume 293, Issue 7602, 10 May 1969, Pages 951-954
The Lancet

ORIGINAL ARTICLES
THE GENETIC FACTOR IN PERNICIOUS ANÆMIA: A Family Study in Patients with Gastritis

https://doi.org/10.1016/S0140-6736(69)91856-XGet rights and content

Abstract

175 relatives of 13 patients with addisonian pernicious anæmia and 13 patients with simple chronic atrophic gastritis were investigated in a family study. The 88 " pernicious anæmia" relatives included a significantly greater number of people with (a) pernicious anæmia or conditions hitherto linked with it (hypochromic microcytic anæmia, diabetes mellitus, primary Addison's disease, vitiligo, and premature greying) and (b) autoantibodies to thyroid and gastric antigens, and there was a significantly increased mortality in the brothers. It is suggested that the gastric lesion of pernicious anaemia is determined by two influences: (1) non-specific damage by various environmental agents, and (2) an inherited defect in immunological tolerance to a specific complex of antigens, resulting in autoimmune reactions to gastric components and other autoantigens. These two influences must interact for the transition from simple gastritis to the gastric lesion of pernicious anæmia. The inherited defect explains the sporadic association of certain other diseases with pernicious anaemia. The increased mortality of the " pernicious anaemia " brothers suggests that the postulated defect in tolerance prejudices survival to old age.

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