Characteristic endoscopic findings in early-stage autoimmune gastritis

Tohru Kotera; Maki Ayaki; Naoki Sumi; Rika Aoki; Katsuhiro Mabe; Kazuhiko Inoue; Noriaki Manabe; Tomoari Kamada; Ryoji Kushima; Ken Haruma

doi:10.1055/a-2215-3284

Characteristic endoscopic findings in early-stage autoimmune gastritis

Endosc Int Open. 2024 Mar 7;12(3):E332-E338. doi: 10.1055/a-2215-3284. eCollection 2024 Mar.

Authors

Tohru Kotera¹, Maki Ayaki², Naoki Sumi³, Rika Aoki⁴, Katsuhiro Mabe⁵, Kazuhiko Inoue⁶, Noriaki Manabe², Tomoari Kamada⁷, Ryoji Kushima⁸, Ken Haruma⁹

Affiliations

¹ Department of Medical Examination, Uji Tokushukai Medical Center, Uji, Japan.
² Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
³ Department of Health Care Medicine, Kawasaki Medical School, Kurashiki, Japan.
⁴ Department of Health Screening, Tokushima Health Screening Center, Tokushima, Japan.
⁵ Department of Gastroenterology, Junpukai Health Maintenance Center-Kurashiki, Kurashiki, Japan.
⁶ Health Care Medicine, Junpukai Health Maintenance Center, Okayama, Japan.
⁷ Department of Health Care Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
⁸ Department of Pathology, Shiga University of Medical Science, Otsu, Japan.
⁹ Department of Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.

Abstract

Background and study aims Until recently, autoimmune gastritis (AIG) was usually diagnosed at late stages based on typical endoscopic findings, including corpus-dominant advanced atrophy. Early-stage AIG prior to complete gastric atrophy had rarely been diagnosed due to a lack of knowledge about its endoscopic characteristics. The present study sought to identify the endoscopic characteristics of early-stage AIG, enabling its early diagnosis. Patients and methods The clinical and endoscopic findings of 12 patients diagnosed with early-stage AIG between 2016 and 2021 were retrospectively evaluated. Patients were included if they were: (1) positive for serum anti-parietal cell antibody; (2) diagnosed with histological early-stage AIG; and (3) endoscopically positive for folds on the greater curvature of the gastric corpus. Results Two characteristic endoscopic findings of early-stage AIG were identified: longitudinal alignment of pseudopolyps (i.e., a bamboo joint-like appearance) and swelling of gastric areas with erythema (i.e., a salmon roe-like appearance). Conclusions Endoscopic findings characteristic of early-stage AIG include a bamboo joint-like appearance and a salmon roe-like appearance. Studies in large numbers of patients with long-term follow-up are needed to confirm these findings.

Keywords: autoimmune gastritis; early stage; endoscopy.

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