杆菌胃炎作为演变的自身免疫性胃炎的初始表现:两例病例的报告
Tohru Kotera1, Ryoji Kushima2, Ken Haruma3
1Department of Medical Examination, Uji-Tokushukai Medical Center, Japan.
Internal medicine (Tokyo, Japan)
|August 6, 2025
概括
自免疫性胃炎 (AIG) 可以从初步诊断的活跃的Helicobacter pylori胃炎中演变. 在H. pylori感染期间识别胃胀和红血对于考虑AIG至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 自身免疫性胃炎 (AIG) 是一种慢性炎症性疾病,影响胃内膜.
- 杆菌感染是胃炎的常见原因,经常出现类似的初始症状.
- 区分H. pylori胃炎和演变的AIG可能是具有挑战性的,因为临床和内镜发现重叠.
研究的目的:
- 报告两个病例,说明从最初的H. pylori胃炎的进展到自身免疫性胃炎.
- 要突出可能在H. pylori感染的背景下暗示AIG的关键临床和内镜特征.
- 强调在活跃的H. pylori感染期间观察到特定的胃变化时考虑AIG的重要性.
主要方法:
- 两名患有自免疫性胃炎的患者的病例报告.
- 根据症状,内镜检查结果 (胃部部位胀,红斑) 和H. pylori状态进行初始诊断.
- 在H. pylori根除疗法或自发H. pylori清除后的后续评估,包括胃粘膜组织病理学检查 (腹腔和体).
主要成果:
- 两位患者最初呈现出活跃的H. pylori胃炎 (胃胀和红血) 的内镜症状.
- 一名患者在H. pylori根除后出现了明显的AIG;另一个患者在H. pylori自发消失后进展.
- 在AIG诊断时,发现了显著的缩变化,特别是胃体的严重缩和腹膜的回归.
结论:
- 自免疫性胃炎最初可能呈现为活跃的H. pylori胃炎,使早期分化变得困难.
- 在活跃的H. pylori感染期间出现胃部胀区域和红血,应考虑演变的AIG.
- 组织病理学评估显示体主导性缩对于诊断AIG至关重要,即使在治疗或清除了H. pylori之后.
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