Anti-Intrinsic Factor Antibodies in Systemic Lupus Erythematosus

Abstract

As the co-existence of pernicious anaemia (PA) and systemic lupus erythematosus (SLE) has been repeatedly reported, we have investigated the presence of anti-intrinsic factor antibodies (IFAb), the immunological hallmark of PA, in patients diagnosed with SLE. Serum cobalamin levels and IFAb were determined in 30 women diagnosed with SLE as well as in 45 controls. Cobalamin levels were low in 7/30 patients. IFAb were detected in 3/30 sera from patients but in none of the control sera. The presence of IFAb was associated with a low cobalamin concentration, anaemia and macrocytosis in only one patient. There was no evident relationship between the presence of IFAb and serological markers of SLE. We conclude that IFAb may appear in SLE patients, although the cobalamin deficiency described in SLE seems to be due to the presence of IFAb in only a minority of cases.

Keywords

Systemic lupus erythematosus Cobalamin Anti-intrinsic factor antibodies

Get full access to this article

View all access options for this article.

References

Cleary LM , Duggan DB Hematologic abnormalities complicating medical disorders. In: Williams WJ , Beutler E , Erslev A et al., eds. Hematology, 4th ed. New York: McGraw-Hill , 1990:1586-7.

Hamilton DV , Reed PI Systemic lupus erythematosus in a patient with Hashimoto's thyroiditis and pernicious anemia. J R Soc Med 1971; 71: 147-9.

Costello M. , Abdelaal M. , Coomes EN Pernicious anemia and systemic lupus erythematosus in a young woman . J Rheumatol 1985; 12: 798-9.

Korbet SM , Corwin HL Pernicious anemia associated with systemic lupus erythematosus. J Rheumatol 1986; 13: 193-4.

Feld S. , Landau Z. , Gefel D. , Green L. , Resnitzky P. Pernicious anemia, Hashimoto's thyroiditis and Sjögren's syndrome in a woman with SLE and autoimmune hemolytic anemia. J Rheumatol 1989 ; 16: 258-9.

Juncà J. , Cuxart A. , Tural C. , Marti S. Systemic lupus erythematosus and pernicious anemia in an 82-year-old woman . J Rheumatol 1991 ; 18:1924-5.

Pitcher CS , Lindsay DJ , Hill Ags. Absorption of vitamin B12 in rheumatoid arthritis. Ann Rheum Dis 1970; 29: 533-6.

Altz-Smith M. , Miller RK , Cornwell PE , Butterworth CE Low serum vitamin B12 in rheumatoid arthritis. Arthritis Rheum 1982; 75 (Suppl 4): S116.

Molad Y. , Rachmilewitz B. , Sidi Y. , Pinkhas J. , Weinberger A. Serum cobalamin and transcobalamin levels in systemic lupus erythematosus . Am J Med 1990; 88: 141-4.

10.

Fairbanks VF , Lennon VA , Kokmen E. , Howard FM Tests for pernicious anemia: serum intrinsic factor blocking antibody. Mayo Clin Proc 1983 ; 58: 203-4.

11.

Irvine WJ Immunological aspects of pernicious anemia. N Engl J Med 1965; 273: 432-8.

12.

Wangel AG , Schiller Kfr. Diagnostic significance of antibody to intrinsic factor. Br Med J 1966; i: 1274-6.

13.

Rose MS , Chanarin I. , Doniach D. , Brostoff J. Intrinsic-factor antibodies in absence of pernicious anemia. Lancet 1970; ii: 9-13.

14.

Twomey JJ , Jordan PH , Jarrold T. , Trubowitz S. , Ritz ND , Conn HO The syndrome of immunoglobulin deficiency and pernicious anemia. A study of ten cases. Am J Med 1969; 47: 340-50.

15.

Comin DB , Hines JD , Wieland RG Coexistent pernicious anemia and idiopathic hypoparathyroidism in a woman . JAMA 1969; 207:1147-9.

16.

Ungar B. , Stocks AE , Martin Fir , Whittingham S. , Mackay IR Intrinsic-factor antibody, parietal-cell antibody and latent pernicious anaemia in diabetes mellitus. Lancet 1968; ii: 415-8.

17.

Tan EM , Cohen AS , Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 1271-7.

18.

Beck WS Neuropsychiatric consequences of cobalamin deficiency. Adv Intern Med 1991; 36: 33-56.

19.

Carmel R. Pernicious anemia. The expected findings of very low cobalamin levels, anemia and macrocytosis are often lacking. Arch Intern Med 1988; 148:1712-4.

20.

Herbert V. Don't ignore low serum cobalamin (vitamin B12) levels. Arch Intern Med 1988; 148: 1705-7.

21.

Callender ST , Spray GH Latent pernicious anaemia. Br J Haematol 1962; 8: 230-40.