Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
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FULLSCREEN > Archive > 2022 > Vol 3, №6 (2022) > Clinical case of endoscopic diagnosis of autoimmune atrophic gastritis

Clinical case of endoscopic diagnosis of autoimmune atrophic gastritis

Ivan V. Smirnov

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  • Abstract
  • About the Author
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Abstract

Autoimmune atrophic gastritis (AIG) is a chronic progressive inflammatory disease that results in damage to the gastric parietal cells and replacement of these cells by atrophic and metaplastic mucosa. In the course of the disease autoantibodies gradually destroy parietal cells, causing hypochlorhydria followed by achlorhydria; vitamin B12 absorption is also impaired. The resulting cobalamin deficiency is manifested by megaloblastic anemia and neurological disorders, the combination referred to as pernicious anemia. AIG is also associated with the increased risk of gastric adenocarcinoma and gastric neuroendocrine tumors, that is why patients diagnosed with AIG should be followed-up. Since metaplastic changes in the mucous membrane are the major histological feature found in patients with autoimmune atrophic gastritis, English sources recommend to use the term “autoimmune metaplastic atrophic gastritis”. It is believed that to date AIG has been found in all populations and ethnic groups, however, there is no reliable data on the prevalence due to complexity of the diagnosis. Endoscopic diagnosis is one of the key tests for the diagnosis of AIG. The paper provides the clinical case of the endoscopic diagnosis of AIG and discusses typical endoscopic features of the disease. 
Key words: autoimmune gastritis, pernicious anemia, neuroendocrine tumors, endoscopy.

About the Author

Ivan V. Smirnov 1

1 Vologda Regional Clinical Hospital, Vologda, Russia

References

1. Park JY, Lam-Himlin D, Vemulapalli R. Review of autoimmune metaplastic atrophic gastritis. Gastrointest Endosc 2013; 77 (2): 284–92. 
2. Toh BH, Sentry JW, Alderuccio F. The causative H+/K+ ATPase antigen in the pathogenesis of autoimmune gastritis. Immunol Today 2000; 21 (7): 348–54. 
3. Carmel R, Johnson CS. Racial patterns in pernicious anemia. Early age at onset and increased frequency of intrinsic-factor antibody in black women. N Engl J Med 1978; 298 (12): 647–50. 
4. Faber K. Achylia gastrica mit Anamie. Med Klin 1909; 5: 1310–25. 
5. Baxter AG, Jordan MA, Silveira PA et al Genetic control of susceptibility to autoimmune gastritis. Int Rev Immunol 2005; 24 (1–2): 55–62. 
6. Ikeda T, Senoue I, Hara M et al Gastric pseudopolyposis: a new clinical manifestation of type A gastritis. Am J Gastroenterol 1985; 80 (2): 82–90. 
7. Krasinskas AM, Abraham SC, Metz DC, Furth EE. Oxyntic mucosa pseudopolyps: a presentation of atrophic autoimmune gastritis. Am J Surg Pathol 2003; 27 (2): 236–41. 
8. Judd LM, Gleeson PA, Toh BH, van Driel IR. Autoimmune gastritis results in disruption of gastric epithelial cell development. Am J Physiol 1999; 277 (1 pt 1): G209–G218. 
9. Chlumska A, Boudova L, Benes Z, Zamecnik M. Autoimmune gastritis. A clinicopathologic study of 25 cases. Cesk Patol 2005; 41 (4): 137–42. 
10. Solcia E, Fiocca R, Villani L et al Hyperplastic, dysplastic, and neoplastic enterochromaffin-like-cell proliferations of the gastric mucosa. Classification and histogenesis. Am J Surg Pathol 1995; 19 (Suppl 1): S1–S7. 
11. Abraham SC, Singh VK, Yardley JH, Wu TT. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol 2001; 25 (4): 500–7. 
12. Dickey W et al. Gastric as well as duodenal biopsies may be useful in the investigation of iron deficiency anaemia. Scand J Gastroenterol. 1997; 32 (5): 469–72. 
13. Office of Rare Diseases Research: Diffuse Gastric Cancer. National Institute of Health. National Institute of Health, 2012; pp. 84–85. Retrieved 2012-11-21. 
14. Toh BH. Diagnosis and classification of autoimmune gastritis. Autoimmun Rev 2014; 13 (4–5): 459–62. 
15. Okano A, Takakuwa H, Matsubayashi Y. Parietal-cell hyperplasia mimicking sporadic fundic gland polyps in the atrophic mucosa of autoimmune gastritis. Gastrointest Endosc 2007; 66 (2): 394–5. 
16. Neumann WL et al. Autoimmune atrophic gastritis – pathogenesis, pathology and management. Nat Rev Gastroenterol Hepatol 2013; 10 (9): 529–41. 
17. Park JY, Lam-Himlin D, Vemulapalli R. Review of autoimmune metaplastic atrophic gastritis. Gastrointest Endosc 2013; 77 (2): 284–92.
18. Uibo R et al. The relationship of parietal cell, gastrin cell, and thyroid autoantibodies to the state of the gastric mucosa in a population sample. Scand J Gastroenterol 1984; 19 (8): 1075–80. 
19. Lahner E et al. Reassessment of intrinsic factor and parietal cell autoantibodies in atrophic gastritis with respect to cobalamin deficiency. Am J Gastroenterol 2009; 104 (8): 2071–9. 
20. Antico A et al. Clinical usefulness of the serological gastric biopsy for the diagnosis of chronic autoimmune gastritis. Clin Dev Immunol 2012; 2012: 520970. 
21. Correa P. A human model of gastric carcinogenesis. Cancer Res 1988; 48 (13): 3554–60. 
22. Vannella L et al. Systematic review: gastric cancer incidence in pernicious anaemia. Aliment Pharmacol Ther 2013; 37 (4): 375–82. 
23. Creutzfeldt W. The achlorhydria-carcinoid sequence: role of gastrin. Digestion 1988; 39 (2): 61–79. 
24. Bordi C, et al. Hypergastrinemia and gastric enterochromaffin-like cells. Am J Surg Pathol 1995; 19 (Suppl. 1): S8–19.

For citation:Smirnov I.V. Clinical case of endoscopic diagnosis of autoimmune atrophic gastritis. Clinical review for general practice. 2022; 6: 30–35. DOI: 10.47407/kr2022.3.6.00173


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