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

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-dominan...

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Autores principales: Kishino, Maiko, Nonaka, Kouichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224887/
https://www.ncbi.nlm.nih.gov/pubmed/35743593
http://dx.doi.org/10.3390/jcm11123523
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author Kishino, Maiko
Nonaka, Kouichi
author_facet Kishino, Maiko
Nonaka, Kouichi
author_sort Kishino, Maiko
collection PubMed
description 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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spelling pubmed-92248872022-06-24 Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images Kishino, Maiko Nonaka, Kouichi J Clin Med Review 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. MDPI 2022-06-19 /pmc/articles/PMC9224887/ /pubmed/35743593 http://dx.doi.org/10.3390/jcm11123523 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kishino, Maiko
Nonaka, Kouichi
Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
title Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
title_full Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
title_fullStr Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
title_full_unstemmed Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
title_short Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
title_sort endoscopic features of autoimmune gastritis: focus on typical images and early images
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9224887/
https://www.ncbi.nlm.nih.gov/pubmed/35743593
http://dx.doi.org/10.3390/jcm11123523
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