Prednisolone and gastric atrophy.

Eight patients with Addisonian pernicious anaemia were given 20 mg of prednisolone daily for up to 20 weeks. Improvement in absorption of vitamin B as judged by the Schilling test occurred in six cases and was pronounced in four, and there was increased secretion of gastric intrinsic factor in four cases. Gastric biopsies showed regeneration of specialized gastric glands in four cases; chief cells were demonstrated histochemically and parietal cells by an immunofluorescent procedure using serum containing parietal cell antibody. There was no correlative change in titre of serum antibody to gastric parietal cells or gastric intrinsic factor. The improved absorption of vitamin B was not maintained after prednisolone was stopped, indicating that the regenerated gastric mucosa reverted to the atrophic state. These effects of corticosteroids on gastric function in pernicious anaemia are in keeping with their known capacity to modify damage resulting from antigen–antibody interaction.