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Mayo Clinic Laboratories

Test ID PCAB Parietal Cell Antibodies, IgG, Serum

Reporting Name

Parietal Cell Ab, IgG, S

Useful For

Evaluating patients suspected of having pernicious anemia or autoimmune-mediated deficiency of vitamin B12 with or without megaloblastic anemia

Specimen Type

Serum

Specimen Required

Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.5 mL

Specimen Minimum Volume

0.45 mL

Specimen Stability Information

Specimen Type	Temperature	Time	Special Container
Serum	Refrigerated (preferred)	21 days
	Frozen	21 days

Reference Values

Negative: ≤20.0 Units

Equivocal: 20.1-24.9 Units

Positive: ≥25.0 Units

Reference values apply to all ages.

Day(s) and Time(s) Performed

Tuesday, Friday; 3 p.m.

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83516

LOINC Code Information

Test ID	Test Order Name	Order LOINC Value
PCAB	Parietal Cell Ab, IgG, S	40960-7

Result ID	Test Result Name	Result LOINC Value
PCAB	Parietal Cell Ab, IgG, S	40960-7

Clinical Information

Pernicious anemia (PA) is a common form of cobalamin (vitamin B12) deficiency anemia.(1) The disorder is characterized by abnormally large (megaloblastic) red blood cells and atrophic body gastritis (ABG) resulting from autoimmune-mediated destruction of parietal cells that line the stomach wall. The destruction of parietal cells leads to impaired production of intrinsic factor (IF) required for the absorption of vitamin B12. PA is frequently associated with other autoimmune conditions such as autoimmune thyroid disease, type 1 diabetes mellitus, and vitiligo.(2-5) Diagnosis of PA relies on histologically proven ABG, peripheral blood examination showing megaloblastic anemia, vitamin B12 deficiency, parietal cell antibodies (PCA) with or without intrinsic factor antibodies (IFA), and elevated serum gastrin from loss of acid secretion.(2-4) PCA bind to the alpha- and beta-subunits of the membrane-bound H(+)/K(+)-ATPase while IFA bind directly to intrinsic factor, blocking its ability to bind vitamin B12.(1,4) Both PCA and IFA are useful diagnostic tests for PA, however, compared to PCA, IFA are more specific and lack diagnostic sensitivity.(2,4,5)

Interpretation

A positive result indicates the presence of IgG antibodies to H(+)/K(+) ATPase and maybe suggestive of pernicious anemia (PA) or a related autoimmune disease.

A negative result indicates no detectable IgG antibodies to H(+)/K(+) ATPase; it does not rule out PA.

An equivocal result is inconclusive for the presence of IgG antibodies to H(+)/K(+)ATPase. Consider re-testing in 4-6 weeks if clinical suspicion for PA is high.

Clinical Reference

1. Toh BH, Van Driel IR, Gleeson PA: Pernicious anemia. N Eng J Med. 1997;337(20):1441-1448

2. Bizzaro N, Antico A: Diagnosis and classification of pernicious anemia. Autoimmun Rev. 2014;13(4-5):565-568

3. Toh BH: Pathophysiology and laboratory diagnosis of pernicious anemia. Immunol Res. 2017;65(1):326-330

4. Lenti MV, Rugge M, Lahner E, et al: Autoimmune gastritis. Nat Rev Dis Primers. 2020 Jul 9;6(1):56

6. Oo TH: Diagnostic difficulties in pernicious anemia. Discov Med. 2019;28(155):247-253

Analytic Time

1 day

Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)

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