Autoimmune Gastritis:Analysis of 161 Clinical Cases
10.3969/j.issn.1008-7125.2024.10.006
- VernacularTitle:自身免疫性胃炎161例临床病例分析
- Author:
Zhou XU
1
;
Cheng YE
;
Linwensi ZHU
;
Xiangping WU
;
Yanjie SHEN
;
Bin LÜ
Author Information
1. 浙江中医药大学附属第一医院消化内科(310006)
- Publication Type:Journal Article
- Keywords:
Autoimmune Gastritis;
Hypergastrinemia;
Endoscopy;
Stomach Neoplasms
- From:
Chinese Journal of Gastroenterology
2024;29(10):610-615
- CountryChina
- Language:Chinese
-
Abstract:
Background:Autoimmune gastritis(AIG)is a CD4+T cell-mediated immune disease.In recent years,with increased awareness and understanding of the condition,reports of AIG cases in China have been gradually increasing.Aims:To analyze and summarize the clinical characteristics of AIG for better disease recognition and diagnosis.Methods:Data on AIG patients diagnosed at the First Affiliated Hospital of Zhejiang Chinese Medical University from August 2018 to December 2023 were collected and analyzed for their clinical,laboratory,endoscopic,and pathological features.Results:A total of 161 AIG patients were included,with the mean age of 56.81 years old,63 were males and 98 females.Most of the patients exhibited no characteristic clinical symptoms.The laboratory measurements were as follows:gastrin-17,44.68 pmol/L;pepsinogen(PG)Ⅰ,38.61 μg/L;PG Ⅱ,10.41 μg/L;PGⅠ/Ⅱ ratio,32.1;vitamin B12,344.45 pmol/L;and hemoglobin,125.15 g/L.The positivity rates of thyroglobulin antibody and thyroid peroxidase antibody were 46.0%and 30.0%,respectively.The main comorbid autoimmune diseases were Hashimoto's thyroiditis(8.1%)and rheumatoid arthritis(5.0%).One hundred and seven cases exhibited the"reverse atrophy"phenomenon,while 54 cases showed pan-gastric atrophy,predominantly in the fundus and body.Fifteen cases were diagnosed as gastric neuroendocrine tumors(NET)or gastric carcinoma.Pathological analysis of 90 gastric mucosal specimens showed 24 cases of lymphocyte and plasma cell infiltration without significant atrophy,42 cases of glandular atrophy and lymphocyte infiltration,and 24 cases of enterochromaffin cell hyperplasia and the formation of endocrine micro-nests.Conclusions:AIG is more common in middle-aged and elderly individuals,with a slightly higher prevalence in females and a frequent association with anemia.It should be suspected in patients with low PGⅠ level and hypergastrinemia.Due to the increased risk of gastric adenocarcinoma and NETs,regular endoscopic monitoring is recommended.
