{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:44:59Z","timestamp":1782297899946,"version":"3.54.5"},"reference-count":31,"publisher":"Walter de Gruyter GmbH","issue":"1","funder":[{"name":"Centre Hospitalier Universitaire d\u2019Angers","award":["Appel d\u2019offre interne (2020)"],"award-info":[{"award-number":["Appel d\u2019offre interne (2020)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_cclm-2025-0671_abs_001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pernicious anemia (PA) is a common cause of vitamin B12 deficiency and requires a robust diagnosis to guide lifelong treatment. Anti-parietal cell antibodies (APCA) are frequently used as a diagnostic marker, but their poor specificity raises concerns about overdiagnosis, particularly in patients lacking the more specific but less sensitive anti-intrinsic factor antibodies (IFA). We compared the diagnostic performance of two APCA detection methods: indirect immunofluorescence (IIF) and immunodot\u00a0assay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0671_abs_002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively enrolled patients with B12 deficiency and APCA positivity without IFA. PA diagnosis was adjudicated by blinded expert based on histology and response to oral B12. Patients were classified as true PA (APCA-PA), false positive (APCA-FP), or undetermined. Only APCA-PA and APCA-FP cases were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0671_abs_003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 56 included patients, 19 were classified as APCA-PA and compared to 24\u00a0APCA-FP. APCA immunodot assay was positive in 19\/19\u00a0APCA-PA vs. 23\/24\u00a0APCA-FP (p&gt;0.99), while APCA IIF was positive in 13\/19\u00a0APCA-PA vs. 2\/24\u00a0APCA-FP (p&lt;0.001), with higher IIF titers among APCA-PA (p&lt;0.001). Only IIF positivity was significantly associated with PA (68.4\u202f% vs. 8.3\u202f%, p&lt;0.001), with 92\u202f% specificity. This association was confirmed in multivariate analysis (OR 37.1 [95\u202f% CI: 6.1\u2013439.4]). APCA IIF titer was also associated with PA diagnosis (AUC 0.82 [95\u202f% CI: 0.68\u20130.96]), and titer\u00a0\u22651:80 further improved specificity to 96\u202f%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_cclm-2025-0671_abs_004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IIF is more specific than immunodot for PA diagnosis, and its result should prevail over immunodot when deciding whether to perform EGD, when EGD is not feasible, and when establishing the diagnosis if biopsies are inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/cclm-2025-0671","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T08:14:53Z","timestamp":1758010493000},"page":"158-165","source":"Crossref","is-referenced-by-count":2,"title":["Not all anti-parietal cell antibody tests are equal for diagnosing pernicious anemia"],"prefix":"10.1515","volume":"64","author":[{"given":"Valentin","family":"Lacombe","sequence":"first","affiliation":[{"name":"Service de M\u00e9decine interne et polyvalente , 708873 Centre Hospitalier du Haut-Anjou , Ch\u00e2teau-Gontier , France"},{"name":"Service de M\u00e9decine interne et immunologie clinique , Centre Hospitalier Universitaire d\u2019Angers , Angers , France"},{"name":"Univ Angers, Inserm, CNRS, MITOVASC, Equipe MitoLab, SFR ICAT , Angers , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5719-8423","authenticated-orcid":false,"given":"Geoffrey","family":"Urbanski","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine interne et immunologie clinique , Centre Hospitalier Universitaire d\u2019Angers , Angers , France"},{"name":"Service d\u2019Immunologie et d\u2019allergologie , H\u00f4pitaux universitaires de Gen\u00e8ve , Geneva , Switzerland"},{"name":"Department of Orofacial Sciences , University of California , San Francisco , CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"2025121815555028081_j_cclm-2025-0671_ref_001","doi-asserted-by":"crossref","unstructured":"Neumann, WL, Coss, E, Rugge, M, Genta, RM. 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Diagnosis and classification of pernicious anemia. 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