The relationship between idiopathic thrombocytopenic purpura and pernicious anaemia

Some reports on the simultaneous presence of chronic idiopathic thrombocyto penic purpura (ITP) and pernicious anaemia (PA) may be found in the literat ure. However, little is known about the coexistence of these autoimmune dis orders. For this reason, we studied the prevalence of PA in a series of pat ients with a diagnosis of chronic ITP by means of the analysis of the conce ntration of the most sensitive marker of type A atrophic (autoimmune) gastr itis, serum pepsinogen I. Serum pepsinogen I was low in 20.3% of the 133 pa tients studied. Gastrin was elevated in 15.2% of patients, but the coexiste nce of both abnormalities was rather low (7.6% of patients). However, the p rogressive decrease in serum cobalamin as biochemical abnormalities related with atrophic gastritis appeared was noticeable. The time to progression t o frank PA from type A atrophic gastritis may span some years.