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DOI: 10.1055/a-2215-3284
Characteristic endoscopic findings in early-stage autoimmune gastritis
Authors
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.
Publication History
Received: 12 May 2023
Accepted after revision: 16 November 2023
Accepted Manuscript online:
21 November 2023
Article published online:
07 March 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Haruma K, Komoto K, Kawaguchi H. et al. Pernicious anemia and Helicobacter pylori infection in Japan: Evaluation in a country with a high prevalence of infection. Am J Gastroenterol 1995; 90: 1107-1110
- 2 Nagao T, Hirokawa M. Diagnosis and treatment of macrocytic anemias in adults. J Gen Fam Med 2017; 18: 200-204
- 3 Notsu T, Adachi K, Mishiro T. et al. Prevalence of autoimmune gastritis in individuals undergoing medical checkups in Japan. Intern Med 2019; 58: 1817-1823
- 4 Terao S, Suzuki S, Yaita H. et al. Multicenter study of autoimmune gastritis in Japan: Clinical and endoscopic characteristics. Dig Endosc 2020; 32: 364-372
- 5 Miceli E, Vanoli A, Lenti MV. et al. Natural history of autoimmune atrophic gastritis: A prospective, single centre, long-term experience. Aliment Pharmacol Ther 2019; 50: 1172-1180
- 6 Kotera T, Oe K, Kushima R. et al. Multiple pseudopolyps presenting as reddish nodules are a characteristic endoscopic finding in patients with early-stage autoimmune gastritis. Intern Med 2020; 59: 2995-3000
- 7 Kotera T, Takemoto T, Kushima R. et al. A case of autoimmune gastritis with fundic gland polyp-like pseudopolyps presenting with nodular enterochromaffin-like cell hyperplasia. Clin J Gastroenterol 2021; 14: 98-102
- 8 Ayaki M, Aoki R, Matsunaga T. et al. Endoscopic and upper gastrointestinal barium X-ray radiography images of early-stage autoimmune gastritis: A report of two cases. Intern Med 2021; 60: 1691-1696
- 9 Kishino M, Yao K, Hashimoto H. et al. A case of early autoimmune gastritis with characteristic endoscopic findings. Clin J Gastroenterol 2021; 14: 718-724
- 10 Kotera T, Yamanishi M, Kushima R. et al. Early autoimmune gastritis presenting with a normal endoscopic appearance. Clin J Gastroenterol 2022; 15: 547-552
- 11 Kotera T, Yoshioka U, Takemoto T. et al. Evolving autoimmune gastritis initially hidden by active Helicobacter pylori gastritis. Case Rep Gastroenterol 2022; 16: 103-109
- 12 Müller H, Rappel S, Wündisch T. et al. Healing of active, non-atrophic autoimmune gastritis by H. pylori eradication. Digestion 2001; 64: 30-39
- 13 Jeffries GH, Todd JE, Sleisenger MH. The effect of prednisolone on gastric mucosal histology, gastric secretion, and vitamin B 12 absorption in patients with pernicious anemia. J Clin Invest 1966; 45: 803-812
- 14 Biondo M, Field J, Toh BH. et al. Prednisolone promotes remission and gastric mucosal regeneration in experimental autoimmune gastritis. J Pathol 2006; 209: 384-391
- 15 Kamada T, Watanabe H, Furuta T. et al. Diagnostic criteria and endoscopic and histological findings of autoimmune gastritis in Japan. J Gastroenterol 2023; 58: 185-195
- 16 Haruma K, Kato M, Inoue K. et al. Kyoto classification of gastritis. 2nd ed. (in Japanese). Nihon Medical Center; Tokyo: 2018
- 17 Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy 1969; 1: 87-96
- 18 Dixon MF, Genta RM, Yardley JH. et al. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996; 20: 1161-1181
- 19 Krasinskas AM, Abraham SC, Metz DC. et al. Oxyntic mucosa pseudopolyps: A presentation of atrophic autoimmune gastritis. Am J Surg Pathol 2003; 27: 236-241
- 20 Park JY, Cornish TC, Lam-Himlin D. et al. Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting. Am J Surg Pathol 2010; 34: 1591-1598
- 21 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: 394-395
- 22 Yokota K, Saito Y, Einami K. et al. A bamboo joint-like appearance of the gastric body and cardia: possible association with Crohn's disease. Gastrointest Endosc 1997; 46: 268-272
- 23 Nomura Y, Moriichi K, Fujiya M. et al. The endoscopic findings of the upper gastrointestinal tract in patients with Crohn's disease. Clin J Gastroenterol 2017; 10: 289-296
- 24 Ikeda T, Senoue I, Hara M. et al. Gastric pseudopolyposis: A new clinical manifestation of type A gastritis. Am J Gastroenterol 1985; 80: 82-90
- 25 McCormack TT, Sims J, Eyre-Brook I. et al. Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy?. Gut 1985; 26: 1226-1232
- 26 Tsukada Y. Studies on the red spots on gastric mucosa in patients with chronic liver disease. Niigata Igakkai Zasshi (Niigata Med J) 1987; 101: 797-803 (in Japanese, Abstract in English)
- 27 Nishino K, Kawanaka M, Manabe N. et al. Portal hypertensive gastropathy in liver cirrhosis: Prevalence, natural history, and risk factors. Intern Med 2022; 61: 605-613
- 28 Furuichi Y, Koyama Y, Abe M. et al. Discrimination between portal hypertensive gastropathy and Helicobacter pylori-related gastritis. Intern Med 2022; 61: 601-603
- 29 Nishizawa T, Watanabe H, Yoshida S. et al. Decreased anti-parietal cell antibody titer in the advanced phase of autoimmune gastritis. Scand J Gastroenterol 2022; 57: 143-148