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Demographic, hematologic, and endoscopic differences between predominant corporeal and antral atrophic gastritis: A
Oana Chibulcutean1, Manuela Rozalia Gabor2, Sergiu-Ioan Frandes3
1"George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania.
Insights
Corporeal atrophic gastritis (CAG) is more common in females and associated with microcytic anemia and normal endoscopic findings. Low hemoglobin and mean corpuscular volume (MCV) predict CAG, distinguishing it from H. pylori-associated atrophic gastritis (AAG).
Area of Science:
- Gastroenterology
- Pathology
- Hematology
Background:
- Corporeal atrophic gastritis (CAG) with enterochromaffin-like cell hyperplasia may indicate autoimmune etiology.
- Helicobacter pylori infection typically causes atrophic gastritis limited to the gastric antrum (AAG).
- Distinguishing between CAG and AAG is crucial for appropriate patient management.
Purpose of the Study:
- To compare demographic, clinical, and endoscopic parameters between patients with CAG and AAG.
- To identify predictors of CAG in an endoscopic population.
Main Methods:
- Retrospective retrieval of demographic, clinical, and pathological data from patients undergoing upper digestive endoscopy.
- Histological confirmation of CAG (n=63) and AAG (n=142).
- Statistical analysis including linear regression models to identify independent predictors.
Main Results:
- Female predominance (69.8%) in the CAG group compared to AAG (46.4%).
- CAG patients exhibited significantly lower hemoglobin, mean corpuscular volume (MCV), and serum iron levels.
- Microcytic anemia was associated with CAG, while macrocytic anemia was not.
- Endoscopies in CAG patients more frequently showed no visible mucosal lesions.
Conclusions:
- Patients with CAG are more frequently female and present with microcytic anemia and normal endoscopic findings compared to AAG patients.
- Low hemoglobin and MCV are independent predictors of CAG on histology.
- Serum iron levels are not predictive of CAG in this population.
Abstract:
The study aimed to assess demographic, clinical, and endoscopic parameters in patients with predominant corporeal atrophic gastritis (CAG) and enterochromaffin-like cell hyperplasia suggestive for autoimmune etiology in comparison with patients presenting Helicobacter pylori atrophic gastritis limited to the gastric antrum (AAG).Demographical, clinical, and pathological data of consecutive patients who underwent an upper digestive endoscopy for bleeding screening risk, symptoms, or anemia in a single endoscopy unit were retrieved. The final study group included 63 patients with CAG and enterochromaffin-like cell hyperplasia on histology and a control group of 142 patients with AAG.Female patients were predominant in the group with CAG versus AAG (69.8% vs 46.4%, P = .002). Microcytic anemia (P < .001), but not macrocytic anemia (P = .14) was associated with CAG, the mean corpuscular volume of erythrocyte (MCV) (82.5 vs 86.5 fl, P = .01), the mean value of serum iron (11.8 vs 14.3 μmol/L, P = .02), and hemoglobin level (11.0 vs 12.7 g/dL P < .01) being significantly lower in patients with CAG versus AAG. Upper digestive endoscopies with no visible mucosal lesions (P = .01) were also more frequent in the patients with CAG, but there were not differences regarding digestive symptoms between groups. The linear regression models revealed that the low hemoglobin (P < .001) and low MCV (P = .03) are the independent variables that can predict CAG on histology, but not the serum iron level (P = .77)Consecutive patients investigated on endoscopy with CAG in comparison with those having AAG are more frequent female, they have microcytic anemia, and no mucosal lesions on endoscopy. The decreased hemoglobin level and low MCV, rather than the serum iron level are predictors for CAG versus AAG on histology in endoscopic population.
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