Anti-intrinsic factor antibodies

Immunology

Pernicious anaemia (also known as Biermer’s disease) is an autoimmune atrophic gastritis, predominantly of the fundus, and is responsible for a deficiency in vitamin B12 (cobalamin) due to its malabsorption. Its prevalence is 0.1% in the general population and 1.9% in subjects over the age of 60 years. Pernicious anaemia represents 20%–50% of the causes of vitamin B12 deficiency in adults. Anti intrinsic factor antibodies do not appear to have a clearly defi ned pathogenic role in the development of gastritis. By contrast, they have a well-documented role in the onset of pernicious anaemia, via the vitamin B12 deficiency they induce. The finding of a low total serum cobalamin level may be further evaluated by testing for anti-intrinsic factor antibodies. If positive, the antibodies have a high positive predictive value (95%) for the presence of pernicious anaemia with a concurrent low false positive rate (1–2%) i.e. a high specificity. It identifies those patients with a need for lifelong cobalamin replacement therapy.2 With regard to diagnostic performance sensitivity is low for anti-intrinsic factor antibodies, in the most recent studies while specificity is 100%. In combination with anti-parietal cell antibodies they yield 73% sensitivity and 100% specificity.

Preparation of Patient: No special preparation.

Sample Type:

Serum (Gold and red cap); Plasma (green and lavender cap)

Temperature: + 4ºC

Turnaround Time:

4 working days

Sample Stability:

Whole blood: unknown.

Separated: RT 8 hours;

14 Days @ + 4ºC

Instrument / Procedure:

Fluoroenzyme immunoassay (Phadia 250)

Units:
Reference Range:

Negative: less than 7 U/mL

Equivocal: 7 - 10 U/mL

Positive: greater than 10 U/mL

Precautions:
Download full Primary Sample Management Document
Source:

Phadia IFU

Accreditation Status:
Yes
No

SAMPLE REQUIREMENTS FOR COAGULATION TESTS

PROCEDURE

Sample Requirements and Collection

  • Patients should be relaxed pre-venepuncture. Excessive stress and exercise will increase FVIII, vWF antigen and fibrinolysis. Venous occlusion should be avoided.
  • Difficult venepuncture with trauma may lead to platelet activation with release of PF4 fromalpha granules.
  • Venous blood should be collected into coagulation tubes containing Sodium Citrate 3.2%, 0.105M, 3ml.
  • Specimens must be mixed immediately post venepuncture to avoid clot activation, by GENTLY inverting the tubes 5 to 10 times.
  • The ratio of whole blood to anticoagulant is crucial. Under-filled specimens will not be processed as over- or under-filled tubes can adversely affect results.
  • Any warfarin treatment should be mentioned on the request form.

Transportation and Storage

  • PT/INR specimens should ideally be analysed within 12 hours of collection and transported to the laboratory at room temperature.
  • APTT and Fibrinogen should ideally be analysed within 4 hours of collection. Where this is not possible please centrifuge at room temperature (RT) @3000rpm (1500g) for at least 15 minutes, and then carefully remove the plasma from the cells, transfer to a fresh plastic plain tube and freeze at -20oC.
  • Non-frozen coagulation specimens should be transported at RT ASAP to avoid deterioration of labile factors V and VIII.
  • Collection of blood through intravenous lines that have been previously flushed with heparin should be avoided. In the event blood is drawn from an indwelling catheter, the line should be flushed with 5ml of saline, and the first 5ml of blood or 6 times the line volume be drawn off and discarded before coagulation tube is filled.

Plasma Sample Stability (CLSI H21-A5)

  • PT 24 hours @ RT or 2 weeks @ -20oC
  • APTT 4 hours @ RT or 2 weeks @ -20oC & 12 Months @ -70oC
  • Fibrinogen - 4 hours @ RT `

ESR Ref Ranges
Units of Measurement
MALE
FEMALE
>50 Years
mm/hr
0 - ≤12
0 - ≤15
<50 Years
mm/hr
0 - ≤8
0 - ≤10
Analyte
Units of Measurement
MALE
FEMALE
WBC
10^9/L
4.0 - 10.0
4.0 - 10.0
RBC
10^12/L
4.5 - 5.5
3.8 - 4.8
HB
g/dL
13.0 - 17.0
12.0 - 15.0
HCT
L/L
0.400 - 0.500
0.360 - 0.460
MCV
fL
83 - 101
83 - 101
MCH
pg
27 - 32
27 - 32
MCHC
g/dL
31.5 - 34.5
31.5 - 34.5
PLT
10^9/L
150 - 410
150 - 410
MPV
fL
N/A
N/A
RDW
%
11.6 - 14.0
11.6 - 14.0
#Neut
10^9/L
2.0 - 7.0
2.0 - 7.0
#Lymph
10^9/L
1.0 - 3.0
1.0 - 3.0
#Mono
10^9/L
0.2 - 1.0
0.2 - 1.0
#Eos
10^9/L
0.02 - 0.50
0.02 - 0.50
#Baso
10^9/L
0.02 - 0.10
0.02 - 0.10
Analyte
Units of Measurement
MALE
FEMALE
WBC
10^9/L
Up to 1 year (6.00-16.00)
Up to 6 years (5.00-15.00)
Up to 12 years (5.00-13.00)
Up to 18 years (3.88-10.49)
Up to 1 year (6.00-16.00)
Up to 6 years (5.00-15.00)
Up to 12 years (5.00-13.00)
Up to 18 years (3.88-10.49)
RBC
10^12/L
Up to 1 year (3.90-5.10)
Up to 12 years (4.00-5.20)
Up to 18 years (4.28-5.59)
Up to 1 year (3.90-5.10)
Up to 12 years (4.00-5.20)
Up to 18 years (3.73-5.02)
HB
g/dL
Up to 1 year (11.1-14.1)
Up to 6 years (11.0-14.0)
Up to 12 years (11.5-15.5)
Up to 18 years (13.5-17.2)
Up to 1 year (11.1-14.1)
Up to 6 years (11.0-14.0)
Up to 12 years (11.5-15.5)
Up to 18 years (11.3-15.2)
HCT
L/L
Up to 1 year (0.300-0.380)
Up to 6 years (0.340-0.400)
Up to 12 years (0.350-0.450)
Up to 18 years (0.381-0.499)
Up to 1 year (0.300-0.380)
Up to 6 years (0.340-0.400)
Up to 12 years (0.350-0.450)
Up to 18 years (0.323-0.462)
MCV
fL
Up to 1 year (72.0-84.0)
Up to 6 years (75.0-87.0)
Up to 12 years (77.0-95.0)
Up to 18 years (83.1-99.1)
Up to 1 year (72.0-84.0)
Up to 6 years (75.0-87.0)
Up to 12 years (77.0-95.0)
Up to 18 years (83.1-99.1)
MCH
pg
Up to 1 year (25.0-29.0)
Up to 6 years (24.0-30.0)
Up to 12 years (25.0-33.0)
Up to 18 years (28.3-33.9)
Up to 1 year (25.0-29.0)
Up to 6 years (24.0-30.0)
Up to 12 years (25.0-33.0)
Up to 18 years (28.3-33.9)
MCHC
g/dL
Up to 1 year (32.0-36.0)
Up to 6 years (31.0-37.0)
Up to 12 years (31.0-37.0)
Up to 18 years (32.1-36.6)
Up to 1 year (32.0-36.0)
Up to 6 years (31.0-37.0)
Up to 12 years (31.0-37.0)
Up to 18 years (32.1-36.6)
PLT
10^9/L
Up to 1 year (200-550)
Up to 6 years (200-490)
Up to 12 years (170-450)
Up to 18 years (164-382)
Up to 1 year (200-550)
Up to 6 years (200-490)
Up to 12 years (170-450)
Up to 18 years (164-382)
RDW
%
No separate paediatric ranges
No separate paediatric ranges
#Neut
10^9/L
Up to 1 year (1.00-7.000)
Up to 6 years (1.50-8.00)
Up to 12 years (2.00-8.00)
Up to 18 years (1.56-6.52)
Up to 1 year (1.00-7.000)
Up to 6 years (1.50-8.00)
Up to 12 years (2.00-8.00)
Up to 18 years (1.56-6.52)
#Lymph
10^9/L
Up to 1 year (3.50-11.00)
Up to 6 years (6.00-9.00)
Up to 12 years (1.00-5.00)
Up to 18 years (1.01-3.13)
Up to 1 year (3.50-11.00)
Up to 6 years (6.00-9.00)
Up to 12 years (1.00-5.00)
Up to 18 years (1.01-3.13)
#Mono
10^9/L
Up to 1 year (0.20-1.00)
Up to 6 years (0.20-1.00)
Up to 12 years (0.20-1.00)
Up to 18 years (1.01-3.13)
Up to 1 year (0.20-1.00)
Up to 6 years (0.20-1.00)
Up to 12 years (0.20-1.00)
Up to 18 years (1.01-3.13)
#Eos
10^9/L
Up to 12 years (0.10-1.00)
Up to 18 years (0.05-0.51)
Up to 12 years (0.10-1.00)
Up to 18 years (0.05-0.51)
#Baso
10^9/L
Up to 1 day (0.00-0.64)
Up to 7 days (0.00-0.25)
Up to 14 years (0.00-0.23)
Up to 18 years (0.02-0.15)
Up to 1 day (0.00-0.64)
Up to 7 days (0.00-0.25)
Up to 14 years (0.00-0.23)
Up to 18 years (0.02-0.15)
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