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[Chronic autoimmune gastritis : a multidisciplinary management]
H Valdes-Socin1, P Leclercq2, M Polus2
1Service d'Endocrinologie, CHU Liège, Belgique.
Revue Medicale De Liege
|November 16, 2019
Summary
Chronic autoimmune gastritis (CAG) involves progressive gastric changes and potential neoplasms. Early diagnosis and multidisciplinary management are crucial for treating CAG and associated autoimmune disorders.
Area of Science:
- Gastroenterology
- Autoimmunology
- Oncology
Background:
- Chronic autoimmune gastritis (CAG) is a spectrum of gastric mucosal changes, progressing from atrophy to neoplasia.
- CAG is linked to autoimmune thyroid disorders (thyrogastric autoimmune syndrome) and potentially Helicobacter pylori infection.
- Gastric hypochlorhydria in CAG causes malabsorption of nutrients and medications, and pernicious anemia due to intrinsic factor deficiency.
Purpose of the Study:
- To review advances in the diagnosis and treatment of Chronic Autoimmune Gastritis (CAG).
- To discuss the association of CAG with autoimmune disorders and neoplasms.
- To highlight the importance of a multidisciplinary approach in managing CAG.
Main Methods:
- Review of current literature on Chronic Autoimmune Gastritis (CAG).
- Analysis of diagnostic methods including serology, endoscopy, and virtual chromoendoscopy.
- Evaluation of treatment strategies for CAG and associated conditions like Type 1 Neuroendocrine Tumors (NETs).
Main Results:
- High-definition endoscopy with virtual chromoendoscopy shows promise for CAG diagnosis and monitoring.
- Type 1 NETs treatment involves endoscopic/surgical resection, somatostatin analogues, and gastrin antagonists like netazepide.
- CAG diagnosis can be supported by serological markers (Hp, pepsinogen, antibodies) and elevated gastrin levels.
Conclusions:
- Effective management of CAG requires a multidisciplinary approach involving various medical practitioners.
- Advances in diagnostic tools and targeted therapies are improving outcomes for CAG and associated autoimmune disorders.
- Understanding the continuum of CAG is essential for early detection and prevention of gastric neoplasms.
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