An investigation of the prevalence and significance of gastric parietal-cell autoantibody in rheumatoid arthritis.

Anti-gamma globulin autoantibodies or rheumatoid factors have been detected in the serum of approximately 70-80 per cent. of patients with rheumatoid arthritis (RA) (Ziff, 1957; Glynn and Holborow, 1960; Singer, 1961; Vaughan and Butler 1962), and antinuclear autoantibodies or factors have been detected in approximately 30 per cent. of patients with the disease (Alexander, Bremner, and Duthie, 1960; Hall, Bardawil, Bayles, Mednis, and Galins, 1960; Beck, 1963; Ward, Johnson, and Holborow, 1964; Pitkeathly and Taylor, 1967). In addition to these non-organ-specific autoantibodies, some workers (Anderson, Goudie, Gray, and Buchanan, 1961; Buchanan, Crooks, Alexander, Koutras, Wayne, and Gray, 1961; Becker, Ferguson, and McConahey, 1963; Becker, Titus, Woolner, and Ferguson, 1963; Kornstad and Kornstad. 1964) but not all (Hijmans, Doniach, Roitt, and Holborow, 1961; Masi, Hartmann, Hahn, Abbey, and Shulman, 1965; Mulhern, Masi, and Shulman, 1966) have noted an increased prevalence of organ-specific thyroid autoantibodies and chronic thyroiditis in patients with RA. The position regarding the prevalence of gastric parietal-cell autoantibodies in RA is not clear, although Roitt, Doniach, and Shapland (1965) have noted that the "incidence is only slightly raised above that of controls". The first purpose of this study was to define the prevalence of gastric parietal-c-ll autoantibody in patients with R', and to compare this with the prevalence found in patients with other forms of arthritis, such as osteo-arthritis, Reiter's disease, psoriatic arthritis, ankylosing spondylitis, and gout. The second purpose of the study was to determine whether the gastric parietal-cell autoantibody found in some patients with RA resulted from a non-organspecific autoantibody which stained the cytoplasm of gastric parietal cells, or whether it was organspecific as in pernicious anaemia (Irvine, Davies, Delamore, and Wynn Williams, 1962; Markson and Moore, 1962; Taylor, Roitt, Doniach, Couchman, and Shapland, 1962; Irvine 1965) and iron deficiency anaemia (Markson and Moore, 1962; Dagg, Goldberg, Anderson, Beck, and Gray, 1964) and associated with chronic atrophic gastritis.