Autoimmune gastritis: relationships with anemia and Helicobacter pylori status

Scand J Gastroenterol. 2017 Jun-Jul;52(6-7):674-677. doi: 10.1080/00365521.2017.1288758. Epub 2017 Feb 17.

Abstract

Background: Autoimmune gastritis (AIG) is a gastric pathologic condition affecting the mucosa of the fundus and the body and eventually leading to hypo-achlorhydria.

Aims: We report our clinical and pathological experience with AIG.

Methods: Data from patients with a diagnosis of AIG seen in the period January 2002-December 2012 were retrieved. Only patients with complete sets of biopsies were analyzed.

Results: Data from 138 patients were available for analysis. Pernicious anemia was present in 25% of patients, iron deficiency anemia was found in 29.7% of patients, hypothyroidism in 23% of patients, type 1 diabetes in 7.9% of patients, and vitiligo in 2.8% of patients. Parietal cell antibodies were positive in 65% of patients, and no patient had serology positive for celiac disease. All gastric biopsies showed glandular atrophy associated with enterochromaffin-like (ECL)-cells hyperplasia, features limited to the mucosa of the fundus and body, and focal glandular intestinal metaplasia. Helicobacter pylori was negative in all cases.

Conclusions: AIG was strongly associated with anemia; atrophy, intestinal metaplasia and ECL hyperplasia in the gastric fundus and body are hallmarks of this condition.

Keywords: Autoimmune gastritis; Helicobacter pylori; duodenal lymphocytosis; endocrine hyperplasia; histology.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Iron-Deficiency / epidemiology*
  • Anemia, Pernicious / epidemiology*
  • Atrophy
  • Autoantibodies / blood
  • Autoimmune Diseases / complications*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Enterochromaffin Cells / pathology
  • Enterochromaffin-like Cells / pathology
  • Female
  • Gastric Fundus / pathology
  • Gastritis / complications*
  • Gastritis / pathology
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Hyperplasia
  • Hypothyroidism / epidemiology
  • Intestines / pathology
  • Italy
  • Male
  • Metaplasia / pathology
  • Middle Aged
  • Parietal Cells, Gastric / immunology
  • Retrospective Studies
  • Vitiligo / epidemiology
  • Young Adult

Substances

  • Autoantibodies