Shuichi Terao1, Shiho Suzuki1, Hiroki Yaita2, Koichi Kurahara2, Johji Shunto3, Takahisa Furuta4, Yasuhiko Maruyama5, Masanori Ito6, Tomoari Kamada7, Rika Aoki8, Kazuhiko Inoue9, Noriaki Manabe10, Ken Haruma11. 1. Department of Gastroenterology, Kakogawa Central City Hospital, Hyogo, Japan. 2. Division of Gastroenterology, Matsuyama Red Cross Hospital, Ehime, Japan. 3. Shunto Clinic, Tokushima, Japan. 4. Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Japan. 5. Department of Gastroenterology, Fujieda Municipal General Hospital, Shizuoka, Japan. 6. Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan. 7. Department of Health Care Medicine, Kawasaki Medical School, Okayama, Japan. 8. Tokushima Health Screening Center, Tokushima, Japan. 9. Junpukai Health Maintenance Center, Okayama, Japan. 10. Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Okayama, Japan. 11. Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.
Abstract
BACKGROUND AND AIM: In Japan, the prevalence of autoimmune gastritis (AIG) is assumed to be very low. With the recent rapid decrease in Helicobacter pylori (Hp) prevalence, reports on AIG are increasing. This multicenter registry study aimed to clarify the characteristics of AIG, especially its endoscopic appearance. METHODS: A total of 245 patients with AIG from 11 institutions in Japan from January 2010 to October 2016 were included, and their clinical and endoscopic findings were evaluated. RESULTS: Mean age was 67.2 ± 11.4 years, and 63.7% of the participants were women. The most common approach to diagnose AIG was endoscopic examination. Repeated incorrect treatment for Hp infection, due to a false-positive result in 13 C-urea breath test, ranked third among the basis for diagnosis of AIG. Associated gastric lesions were type 1 neuroendocrine tumor (11.4%), adenocarcinoma (9.8%), and hyperplastic polyps (21.1%). Corpus pan-atrophy was the most common appearance (90.1%); however, remnant oxyntic mucosa was found in 31.5% of the patients (flat, localized type, 48.6%). Sticky adherent dense mucus and scattered minute whitish protrusions were also observed in approximately 30% of the patients. Despite the prevailing presumption of the antral mucosa remaining normal, 42.3% of the patients presented with various extents of atrophy, and patchy redness and circular wrinkle-like patterns were both observed in approximately 20% of the patients. CONCLUSIONS: The present study showed some prominent clinical characteristics and endoscopic findings of AIG. We believe that our study will facilitate the diagnosis of potential AIG.
BACKGROUND AND AIM: In Japan, the prevalence of autoimmune gastritis (AIG) is assumed to be very low. With the recent rapid decrease in Helicobacter pylori (Hp) prevalence, reports on AIG are increasing. This multicenter registry study aimed to clarify the characteristics of AIG, especially its endoscopic appearance. METHODS: A total of 245 patients with AIG from 11 institutions in Japan from January 2010 to October 2016 were included, and their clinical and endoscopic findings were evaluated. RESULTS: Mean age was 67.2 ± 11.4 years, and 63.7% of the participants were women. The most common approach to diagnose AIG was endoscopic examination. Repeated incorrect treatment for Hp infection, due to a false-positive result in 13 C-urea breath test, ranked third among the basis for diagnosis of AIG. Associated gastric lesions were type 1 neuroendocrine tumor (11.4%), adenocarcinoma (9.8%), and hyperplastic polyps (21.1%). Corpus pan-atrophy was the most common appearance (90.1%); however, remnant oxyntic mucosa was found in 31.5% of the patients (flat, localized type, 48.6%). Sticky adherent dense mucus and scattered minute whitish protrusions were also observed in approximately 30% of the patients. Despite the prevailing presumption of the antral mucosa remaining normal, 42.3% of the patients presented with various extents of atrophy, and patchy redness and circular wrinkle-like patterns were both observed in approximately 20% of the patients. CONCLUSIONS: The present study showed some prominent clinical characteristics and endoscopic findings of AIG. We believe that our study will facilitate the diagnosis of potential AIG.