Autoimmune gastritis among T1D individuals – important association?

The incidence of type 1 diabetes (T1D) is increasing. T1D and other autoimmune diseases have a similar, cell-specified pathogenesis. Due to an increased risk of autoimmune reactions, T1D subjects are statistically more often affected by other autoimmune diseases. During the course of the disease, patients with diabetes may develop, among others, anemia. When the classic and most common causes are excluded, a possibility of a concomitant autoimmune disorder has to be considered. In such cases, the differential diagnosis should  include autoimmune atrophic gastritis (AAG). The symptoms of AAG are: iron deficiency microcytic anemia and, thereafter, macrocytic anemia resultant from B12 vitamin deficiency, although nonspecific neurologic disorders may precede the diagnosis. Because autoimmune gastritis (AG) and its severe stage – pernicious anemia (PA) develop unperceptively over many years, often without any symptoms and frequently remain undiagnosed, physicians should closely screen T1D patients. Anti-parietal cell antibodies (APCA), targeting the gastric proton pump – the H+/K+ ATP-ase, are an advantageous tool for AAG screening, and are significantly more frequent among T1D subjects in comparison to the healthy population. That indicates an increased risk of AG. Some authors suggest that patients with T1D need to undergo a regular screening which includes: APCA, complete blood count, vitamin B12, iron and gastrin serum concentrations. Nevertheless, presently none of the official international or national guidelines for T1D treatment mention regular screening for AG.