Autoimmune gastritis

From the Global Autoimmune Institute List Only

Summary

Characterized by the destruction of parietal cells, which are cells in the stomach that make stomach acid and a protein called intrinsic factor that is needed to absorb the essential vitamin B12, autoimmune gastritis causes vitamin B12 deficiency which can lead to subsequent illnesses such as anemia.

(Global Autoimmune Institute, 2023)

Symptoms

Gnawing or burning ache or pain (indigestion) in upper abdomen, nausea, vomiting, a feeling of fullness in the upper abdomen after eating, and malabsorption of iron, vitamin B12, or other micronutrients.

(Global Autoimmune Institute, 2023)

Working Diagnostic Criteria

There is no gold standard for the diagnosis of CAG {Chronic autoimmune gastritis}, so the diagnosis is established on the basis of a set of data from a survey and examination of a patient, as well as the results of laboratory and instrumental research methods (Livzan et. al, 2021).

(Livzan et. al, 2021)

…it is necessary to perform a biopsy from at least four points: from the stomach’s antrum and body, along the lesser and greater curvature…The recommended frequency of endoscopic examination in patients with autoimmune gastritis is once every 3–5 years. (Livzan et. al, 2021)

Stomach tissue from the biopsy samples is assessed for characteristic changes:

• in the stomach’s antrum, pathology findings can range from

  • normal tissue to “mononuclear inflammatory infiltrate, focal absolute, and/or metaplastic atrophy”

  • signs of “foveolar hyperplasia (“reactive gastropathy”)” are present in many patients

  • overgrowth of gastrin-producing cells is present

• in the mucus membrane of the stomach’s body there are signs of a wide range of damaging changes, from “minimal signs of inflammation to severe atrophy of the glands.” Pictures and descriptions can be found here.

(Livzan et. al, 2021)

Diagnostic Tests

See Working Diagnostic Criteria. Non-specific tests that may point to further workup include checking blood levels of iron, ferritin (the storage form of iron) and Vitamin B12.

Human Leukocyte Antigen (HLA) Associations

HLA-D8 and HLA-DR-3 haplotypes (Neumann et. al, 2013).

Tissue-Type or Cell-Type Attacked

Parietal cells, α- and β- subunits of H +/K + -ATPase in the stomach (Livzan et. al, 2021). Antibodies to parietal cells in the stomach “recognize the gastric proton pump (H+/K + -ATPase) within the parietal cells in the gastric mucosa as an autoantigen” (Kalkan & Soykan, 2016).

Attacking Immune Cell Type or Process

Under Investigation

Treatment Modality

Under Investigation

Managing Specialist(s)

Under Investigation

Associated Infections

• Helicobacter pylori (Livzan et. al, 2021).

• There is a higher detection rate of autoimmune gastritis in children infected with Epstein–Barr virus (Volynets, 2005).

Associated Toxins

Under Investigation

Research Authors

Under Investigation

Research Institutions

Under Investigation

Average Time from Symptom Onset to Diagnosis

Under Investigation

Last Updated

January 27, 2023

References

Autoimmune gastritis. Global Autoimmune Institute. (2023). Retrieved January 27, 2023 from https://www.autoimmuneinstitute.org/autoimmune-gastritis/

Kalkan Ç, Soykan I. Differences between older and young patients with autoimmune gastritis. Geriatr Gerontol Int. 2017 Jul;17(7):1090-1095. doi: 10.1111/ggi.12832. Epub 2016 Jul 22. PMID: 27444719.

Livzan MA, Gaus OV, Mozgovoi SI, Bordin DS. Chronic Autoimmune Gastritis: Modern Diagnostic Principles. Diagnostics (Basel). 2021 Nov 15;11(11):2113. doi: 10.3390/diagnostics11112113. PMID: 34829460; PMCID: PMC8621657.

Neumann W.L., Coss E., Rugge M., Genta R.M. Autoimmune atrophic gastritis—Pathogenesis, pathology and management. Nat. Rev. Gastroenterol. Hepatol. 2013;10:529–541. doi: 10.1038/nrgastro.2013.101.

Volynets G.V. Klinicheskie i diagnosticheskie osobennosti i printsipy terapii autoimmunnogo gastrita u detey. Det. Gastroenterol. 2005;3:33–37.