Recovery of Gastric Mucosal Structure and Function in Pernicious Anemia During Prednisolone Therapy

A patient with pernicious anemia was treated with prednisolone, 20 mg daily, for 4 months. During this therapy, there was a return of acid and intrinsic factor secretion, normal vitamin B₁₂ absorption, and a regeneration of gastric mucosal glands containing abundant chief and parietal cells. Although there was a decrease in the titer of intrinsic factor antibody in the patient's serum, there was no change in the titer of parietal cell antibodies. This steroid effect is consistent with the hypothesis that gastric mucosal atrophy in pernicious anemia is due to autoimmune destruction of the gastric glands, and that prolonged suppression of these immunologic processes may lead to mucosal regeneration with acid and intrinsic factor secretion.