Early autoimmune gastritis presenting with a normal endoscopic appearance

Kotera, Tohru; Yamanishi, M.; Kushima, Ryoji; Haruma, Ken

doi:10.1007/s12328-022-01617-5

Cited by 8 publications

(13 citation statements)

References 18 publications

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“…Recently, a case of early‐stage AIG was reported with a normal endoscopic appearance 9 . However, in this report, despite milder lymphocyte infiltration in the lesser curvature of the gastric corpus compared to the greater curvature (where lymphocyte infiltration was dense), the contour of the mucosal layer was disorganized with obscured layer boundaries even in the lesser curvature.…”

Section: Discussionmentioning

confidence: 65%

Histopathologic diagnosis of ultra‐early autoimmune gastritis: A case report

Terao

Suzuki

Kushima

2023

Clinical Case Reports

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Section: Discussionmentioning

confidence: 65%

Histopathologic diagnosis of ultra‐early autoimmune gastritis: A case report

Terao

Suzuki

Kushima

2023

Clinical Case Reports

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“…Recently, early-stage AIG without severe mucosal atrophy has been reported [30,[37][38][39][40][41]. Kotera et al [37] reported two cases of early-stage AIG in a 48-year-old man and a 70-year-old woman.…”

Section: Early Stagementioning

confidence: 99%

“…In addition, sticky adherent dense mucus and remnant oxyntic mucosa may be observed in the corpus [26][27][28][29][30][31]. Moreover, magnified endoscopic findings [32][33][34], such as white globe appearance (WGA) [35,36] and cast-off skin appearance (CSA) [36], have been reported, with few reports of early-stage AIG in which reverse atrophy has not fully developed [30,[37][38][39][40][41].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic criteria and endoscopic and histological findings of autoimmune gastritis in Japan

Kamada

Watanabe²,

Furuta

et al. 2023

J Gastroenterol

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The Japanese diagnostic criteria for autoimmune gastritis (AIG) were established by the “Study Group on the establishment of diagnostic criteria for type A gastritis,” which is related to a workshop associated with the Japan Gastroenterological Endoscopy Society (JGES) and the Committee of AIG Research Group (CARP). The criteria were set as follows: the cases of confirmed diagnosis are patients in whom either the endoscopic or histological findings, or both, meet the requirements for AIG and who are confirmed to be positive for gastric autoantibodies (either anti-parietal cell or anti-intrinsic factor antibodies, or both). The presentation of endoscopic findings of early-stage AIG in the diagnostic criteria was withheld owing to the need for further accumulation and characterization of endoscopic clinical data. Therefore, diagnosis of early-stage AIG only requires histological confirmation and gastric autoantibody positivity. Suspected cases are patients in whom either the endoscopic or histological findings, or both, meet only the requirements for AIG. Histological findings only meet the requirements for early stage. AIG has been underdiagnosed in the past, but our study group’s newly proposed diagnostic criteria will enable a more accurate and early diagnosis of AIG. The criteria can be used to stratify patients into various high-risk groups for gastric tumors and pernicious anemia. They would allow the establishment of an appropriate surveillance system in the coming years. Nevertheless, issues such as establishing the endoscopic findings of early-stage AIG and obtaining Japanese insurance coverage for gastric autoantibody tests require attention.

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“…Typical extensive severe atrophic gastritis was not observed using endoscopy. Kotera et al recently reported an early case of AIG that could only be described as presenting completely normal mucosa [ 40 ]. In that case, steroid treatment for interstitial pneumonia was performed for a period of time, but PCA increased, and IFA became positive during the subsequent course.…”

Section: Findings Of Early Aigmentioning

confidence: 99%

Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images

Kishino

Nonaka

2022

JCM

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Autoimmune gastritis (AIG) is chronic atrophic gastritis caused by an autoimmune mechanism of unknown etiology and presents with various pathological conditions by causing an achlorhydria state through parietal cell damage. The most characteristic endoscopic finding in AIG is advanced corpus-dominant mucosal atrophy. A recent study that examined several cases in Japan revealed the presence of endoscopic features other than corpus-dominant advanced atrophy. Remnants of oxyntic mucosa and sticky adherent dense mucus were found in ≥30% of cases, and hyperplastic polyps were found in ≥20% of cases. In image-enhanced endoscopy (IEE), white globe appearance (WGA) was observed in 32% of AIG cases. Additionally, some reports have stated that the findings in AIG cases using IEE showed cast-off skin appearance (CSA) and foveola type mucosa; however, a consensus is yet to be achieved. These endoscopic results were found in cases of advanced-stage AIG. There have been few reports concerning early-stage AIG cases. In these few reports, all of the cases were pathologically diagnosed as early AIG. In all of the cases, the pathological findings almost always showed neither parietal cell destruction nor atrophy. Endoscopic findings such as “mosaic pattern with slight swelling of the areae gastricae”, “diffuse reddened and edematous gastric fundic gland mucosa”, and “pseudopolyp-like nodules” may be common characteristics of early images. In such early cases, high antibody titers, no atrophic changes, and few clinical abnormal findings were shown. Endoscopists are expected to update their knowledge regarding AIG diagnosis with the evolution of imaging equipment.

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Early autoimmune gastritis presenting with a normal endoscopic appearance

Cited by 8 publications

References 18 publications

Histopathologic diagnosis of ultra‐early autoimmune gastritis: A case report

Histopathologic diagnosis of ultra‐early autoimmune gastritis: A case report

Diagnostic criteria and endoscopic and histological findings of autoimmune gastritis in Japan

Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images

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