A case of early autoimmune gastritis with characteristic endoscopic findings
Open Access
- 10 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Clinical Journal of Gastroenterology
- Vol. 14 (3), 718-724
- https://doi.org/10.1007/s12328-021-01351-4
Abstract
Significant atrophic gastritis in the fundic gland region is a well-known endoscopic finding observed in autoimmune gastritis (AIG). The endoscopic features of early AIG have not been reported. Iron deficiency, vitamin B12 deficiency, anemia, or neurological symptoms may not be observed in the early stages of AIG, and it may thus be difficult to diagnose early AIG based on clinical findings. We treated a 50-year-old Japanese female whose condition was suspected to be early AIG. The endoscopic findings showed normal gastric pyloric gland mucosa, and diffuse reddened and edematous gastric fundic gland mucosa. Pathologically, local infiltration of lymphocytes and decrease of parietal cells was present in a deep part of the gastric fundic gland mucosa. Blood tests showed that the titer of parietal cell antibody (PCA) was 1:320 and the gastrin level was 820 pg/ml. We determined that the patient had AIG because she also had Hashimoto’s disease, the PCA titer was high, the serum gastrin level was slightly increased, and inflammation was observed only in the gastric body on the endoscopic images. To the best of our knowledge, this is the first case report of endoscopic findings that suggest early AIG, before atrophic changes were observed.Keywords
This publication has 8 references indexed in Scilit:
- Multicenter study of autoimmune gastritis in Japan: Clinical and endoscopic characteristicsDigestive Endoscopy, 2019
- Features of the Atrophic Corpus Mucosa in Three Cases of Autoimmune Gastritis Revealed by Magnifying EndoscopyCase Reports in Medicine, 2012
- Autoantibodies to parietal cells as predictors of atrophic body gastritis: A five-year prospective study in patients with autoimmune thyroid diseasesAutoimmunity Reviews, 2010
- A New Diagnostic VS Classification System Produced by Magnification Endoscopy Plus Narrow-Band Imaging in the Stomach: Microvascular Architecture and Microsurface StructurePublished by Springer Science and Business Media LLC ,2009
- Autoimmune Gastritis: Distinct Histological and Immunohistochemical Findings Before Complete Loss of Oxyntic GlandsLaboratory Investigation, 2002
- Relationships among serum pepsinogen I, serum pepsinogen II, and gastric mucosal histology. A study in relatives of patients with pernicious anemia.1982
- Relationships Among Serum Pepsinogen I, Serum Pepsinogen II, and Gastric Mucosal HistologyGastroenterology, 1982
- A reappraisal of the nature and significance of chronic atrophic gastritisDigestive Diseases and Sciences, 1973