Which of the following condition is associated with hypergastrinemia with hypochlorhydria?
Pernicious anemia gastritis is an autoimmune disorder involving the fundic parietal glands which results in achlorhydria. Achlorhydria in turn leads to pronounced hypergastrinemia (> 1000 pg/mL) due to loss of acid inhibition of gastrin G cells. Anti-parietal cell antibodies are present in over 90% cases and anti-intrinsic factor antibodies are present in 70% of patients. Decreased intrinsic factor secretion, leads to vitamin B12 malabsorption. Fundic histology in pernicious anemia is characterized by severe gland atrophy and intestinal metaplasia caused by autoimmune destruction of the gastric fundic mucosa. Complications: Hypergastrinemia may induce hyperplasia of gastric enterochromaffin-like cells that leads to the development of small, multicentric carcinoid tumors in 5% of patients and there is a three fold increased risk of gastric adenocarcinoma. Ref: Current Medical Diagnosis and Treatment, 2012, Chapter 15 ; Harrisons Internal Medicine, 18th Edition, Chapter 350 ; Williams Hematology, 8th Edition, Chapter 41
VIPoma
Glucagonoma
Pernicious anemia
Zollinger Ellison Syndrome