Which of the following conditions would mostly likely be associated with chronic gastritis (Type A) resulting from autoimmune destruction of parietal cells?
Autoimmune destruction of parietal cells would lead to decreased secretion of gastric acid and intrinsic factor. The diminished availability of intrinsic factor would result in poor absorption of dietary vitamin B12. Over time, the vitamin B12 deficiency could lead to pernicious anemia, which is characterized by increased production of macrocytes (megaloblasts) by the bone marrow. Because of the decrease in gastric acid secretion, luminal bacteria would most likely exhibit increased (not decreased) growth. One of the functions of HCl secreted by the parietal cells is to sterilize the gastric lumen. Patients with Type A gastritis have an increased likelihood of developing gastric carcinoma (not decreased,). A decrease in acid secretion leads to increased secretion of gastrin (not decreased) by antral G cells. This is because low gastric pH (less than 3) inhibits gastrin secretion paracrine release of somatostatin from cells in the gastric mucosa that can sense the acidity. With decreased parietal cells, the pH of the gastric lumen would rise and remove this inhibitory component. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 14. Gastrointestinal Pathology. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds), Pathology: The Big Picture.
Decreased growth of luminal bacteria
Decreased likelihood of developing gastric carcinoma
Decreased plasma concentration of gastrin
Increased production of macrocytic red blood cells