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Introduction ⬇

The disruption of normal intrinsic factor production or function due to autoimmune processes can lead to pernicious anemia. Antibodies to two antigens of the gastric parietal cell—antiparietal cell antibodies (APCAs) and intrinsic factor blocking antibodies—are found in patients with pernicious anemia (>80%).

This measurement is helpful in diagnosing chronic gastric disease and differentiating autoimmune pernicious anemia from other megaloblastic anemias. Persons with other anemias do not have detectable APCAs.

Normal Findings ⬆ ⬇

Procedure ⬆ ⬇

  1. Collect a 7-mL blood serum sample in a red-topped tube. Observe standard precautions.

  2. Label the specimen with the patient’s name, date, and test(s) ordered and place in a biohazard bag for transport to the laboratory.

Clinical Implications ⬆ ⬇

  1. APCAs occur in >80% of patients with autoimmune pernicious anemia; 50% have antibodies to intrinsic factor.

  2. Occasionally, APCAs are present in the following conditions:

    1. Gastric ulcer

    2. Gastric cancer

    3. Atrophic gastritis

    4. Thyroid disease

    5. Diabetes

    6. Iron-deficiency anemia

Interventions ⬆ ⬇

Pretest Patient Care

  1. Explain test purpose and procedure.

  2. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Review test results; report and record findings. Modify the nursing care plan if needed. Detection of APCA may suggest need for more invasive testing, such as gastric biopsy to rule out gastrointestinal disease.

  2. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Interfering Factors ⬆

APCAs are present in many healthy adults younger than 60 years.