Related Experiment Video
Updated: Jun 21, 2025
Author Spotlight: Generation of and Comparison Between Patient-Derived Gastric Organoids from Different Regions of the Stomach
Published on: January 26, 2024
Clinical characteristics and outcomes of pediatric patients with autoimmune gastritis
Maya Granot1,2, Beate C Beinvogl3, Michael Schvimer2,4
1Pediatric Gastroenterology and Nutrition Unit, Edmond and Lily Safra Children's Hospital, Ramat Gan, Israel.
Insights
Autoimmune gastritis in children often presents as iron deficiency anemia. Close monitoring is crucial due to high rates of metaplasia and potential for gastric neuroendocrine tumors.
Area of Science:
- Pediatric Gastroenterology
- Autoimmune Disorders
- Gastrointestinal Neoplasia
Background:
- Autoimmune gastritis (AIG) is a rare chronic inflammatory condition.
- Pediatric AIG has limited data regarding its natural history and long-term outcomes.
- Potential sequelae include gastric neoplasia, necessitating further investigation in pediatric cases.
Purpose of the Study:
- To characterize the clinical course and outcomes of pediatric autoimmune gastritis.
- To identify key clinical manifestations and associated conditions in children with AIG.
- To assess the long-term sequelae, including metaplasia and neoplasia, in pediatric AIG.
Main Methods:
- Multicenter retrospective study of pediatric patients diagnosed with AIG between 2000 and 2021.
- AIG diagnosis confirmed by histological corpus-predominant atrophic gastritis, with or without positive antiparietal cell (APCA) or anti-intrinsic factor (IF) antibodies.
- Data collection included demographics, clinical, laboratory, endoscopic, and histologic findings, along with follow-up information.
Main Results:
- Thirty-three pediatric patients (69.7% female, median age 12.0 years) were identified.
- Iron deficiency anemia was the most common presentation (75%).
- High rates of metaplasia (24% at diagnosis, 33% developed during follow-up) and one gastric neuroendocrine tumor were observed; no endoscopic or histologic improvements noted.
Conclusions:
- Autoimmune gastritis should be considered in pediatric patients with autoimmunity and refractory iron-deficiency anemia.
- Helicobacter pylori infection does not appear to be associated with pediatric AIG.
- The significant rates of metaplasia and the occurrence of a neuroendocrine tumor underscore the need for vigilant surveillance in pediatric AIG.
Objectives:
Autoimmune gastritis (AIG) is a rare chronic inflammatory disorder with potential long-term sequelae including gastric neoplasia. There is limited data on the natural history of pediatric AIG. We aimed to characterize the clinical course and outcomes of children with AIG.
Methods:
This was a multicenter retrospective study that included pediatric patients diagnosed with AIG between January 1, 2000 and December 31, 2021. Diagnosis of AIG was based on the demonstration of histological corpus-predominant atrophic gastritis, with or without positive antiparietal cell (APCA) or anti-intrinsic factor (IF) antibodies. Demographic, clinical, laboratory, endoscopic, and histologic data were retrieved, along with follow-up data.
Results:
Thirty-three patients, (23 females [69.7%], median age 12.0 [interquartile range 7.0-15.0] years at diagnosis) were identified. Twenty-two patients (66.7%) had positive APCA and/or anti-IF serology. The most common presenting manifestation was iron deficiency anemia (75%), and accompanying autoimmune disorders were significantly more common in patients with positive serology (62% vs. 18%, p < 0.05). Pseudo-pyloric or intestinal-type metaplasia was present at diagnosis in eight patients (24%), and 11 additional patients (33%) developed metaplasia during a median follow-up time of 27 (17.5-48.3) months. One patient developed a type 1 gastric neuroendocrine tumor. Helicobacter pylori was identified in only one patient, while two patients had prior eradication. Endoscopic and histologic improvements weren't identified in any patients.
Conclusions:
AIG should be considered in patients with autoimmunity and resistant iron-deficiency anemia. H. pylori infection may not be associated with pediatric AIG. The development of neuroendocrine tumor in one patient, and the high rates of metaplasia, highlight the importance of surveillance.
More Related Videos
Related Concept Videos
01:27Gastritis-I: Introduction and Types
Acute gastritis presents as a sudden inflammation triggered by various stressors to the stomach lining, such as exposure to corrosive agents, local irritants like aspirin and other NSAIDs, alcohol consumption, radiation therapy, physical trauma, severe burns, sepsis,...
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:17Gastritis-II: Pathophysiology
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:30Other Disorders of Digestive System