Autoimmune atrophic gastritis with hypergastrinemia

Area of Science:

• Gastroenterology
• Immunology
• Pathology

Background:

• Persistent upper abdominal pain can indicate various gastrointestinal issues.
• Peptic ulcer disease is a common cause of upper abdominal pain.
• Chronic atrophic gastritis requires further investigation for underlying causes.

Observation:

• Three patients presented with persistent upper abdominal pain.
• Endoscopy revealed chronic atrophic gastritis.
• Gastric biopsies showed inflammation, reduced parietal cells, and intestinalization.

Findings:

• Elevated fasting serum gastrin levels were observed.
• Total achlorhydria confirmed after histalog stimulus.
• Parietal cell antibodies were present in all patients.
• Serum vitamin B12 and Schilling test results were normal.

Implications:

• These findings indicate autoimmune (type A) chronic atrophic gastritis.
• Distinguishing type A from type B gastritis is crucial.
• Patients need regular observation for pernicious anemia and gastric carcinoma.