Pernicious anaemia in the Chinese: a clinical and immunological study.

Only three Chinese subjects with Addisonian pernicious anaemia have been diagnosed in a busy haematological clinic in Hong Kong during the past 15 years. The three patients are documented. The incidence of parietal cell and intrinsic factor antibody I in the sera of 102 Chinese thyrotoxic patients was found to be comparable to that previously reported in British thyrotoxic subjects. As in the British, a correlation was observed in the Chinese thyrotoxics between the presence of gastric antibodies in the serum and atrophic gastritis. The severity of atrophic gastritis as determined by acid secretion and biopsy was comparable to that seen in British thyrotoxic subjects, but the Schilling tests in the Chinese revealed less severe degrees of mal-absorption of vitamin B. When pernicious anaemia occurred in the Chinese, it appeared to be identical to that occurring in Western populations. Its rarity among the Chinese may be partly due to a genetic factor which may prevent the terminal stages of autoimmune atrophic gastritis from culminating in pernicious anaemia and to an environmental factor such as a high dietary intake of vitamin B by the Chinese.