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Early autoimmune gastritis presenting with a normal endoscopic appearance
Tohru Kotera1, Masayoshi Yamanishi2, Ryoji Kushima3
1Department of Medical Examination, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan. tohru.k326@hotmail.co.jp.
Clinical Journal of Gastroenterology
|March 7, 2022
Summary
Early-stage autoimmune gastritis (AIG) can present without endoscopic changes. This case highlights the importance of serological markers and histopathology for diagnosing AIG in patients with a history of vitamin B12 deficiency.
Area of Science:
- Gastroenterology
- Immunology
- Pathology
Background:
- Autoimmune gastritis (AIG) is an autoimmune disease affecting the stomach lining.
- Early diagnosis is crucial for managing potential complications like vitamin B12 deficiency.
Observation:
- A 66-year-old man with autoimmune thyroiditis was evaluated for suspected AIG.
- He had a history of vitamin B12 deficiency and positive autoantibodies (anti-parietal cell and anti-intrinsic factor).
- Endoscopic examination revealed a normal appearance, with no visible atrophic or inflammatory changes.
Findings:
- Histopathology showed mild atrophic changes and lymphocytic infiltration in the gastric corpus.
- Focal destruction of parietal cells and pseudo-pyloric metaplasia were observed.
- Elevated gastrin levels and normal pepsinogen I levels were noted.
Implications:
- This case demonstrates that early-stage AIG may not be detected by endoscopy alone.
- Serological markers and detailed histopathological analysis are essential for accurate AIG diagnosis.
- Highlights the need for vigilance in patients with autoimmune conditions and a history of B12 deficiency.
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