Current opinion in gastroenterology · 2009
Corpus predominant gastritis: what does it mean?
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El-Zimaity Hala
Аннотация
PURPOSE OF REVIEW: To summarize this year's relevant literature on the causes and mechanisms of autoimmune gastritis.
RECENT FINDINGS: It is increasingly recognized that parietal cell antibodies, previously assumed exclusive to autoimmune gastritis, are associated with Helicobacter pylori infection. Successful H. pylori eradication with antibiotic treatment decreases antiparietal cell antibodies. Interestingly, vitamin B(12) deficiency, previously associated with autoimmune gastritis, is increasingly described in the elderly, irrespective of H. pylori status. Autoimmune gastritis that mostly affects patients of Scandinavian descent, was reported this year from China, and corpus predominant gastritis (autoimmune associated) was reported from Japan. It is difficult to evaluate the role played by genetics, increased use of proton pump inhibitors, and H. pylori infection, as current patient work-up does not regularly include screening for parietal cell and intrinsic-factor antibodies. As these clinicopathologic changes are seen in both H. pylori-positive patients, and in H. pylori-naïve patients, the debate continues for mechanisms involved in H. pylori-naïve patients.
SUMMARY: The clinical features commonly associated with autoimmune gastritis are increasingly seen in the elderly, irrespective of H. pylori status. Though some patients are genetically predisposed, long-term proton pump inhibitor use increases the prevalence of clinicopathologic features irrespective of genetic tendency.
RECENT FINDINGS: It is increasingly recognized that parietal cell antibodies, previously assumed exclusive to autoimmune gastritis, are associated with Helicobacter pylori infection. Successful H. pylori eradication with antibiotic treatment decreases antiparietal cell antibodies. Interestingly, vitamin B(12) deficiency, previously associated with autoimmune gastritis, is increasingly described in the elderly, irrespective of H. pylori status. Autoimmune gastritis that mostly affects patients of Scandinavian descent, was reported this year from China, and corpus predominant gastritis (autoimmune associated) was reported from Japan. It is difficult to evaluate the role played by genetics, increased use of proton pump inhibitors, and H. pylori infection, as current patient work-up does not regularly include screening for parietal cell and intrinsic-factor antibodies. As these clinicopathologic changes are seen in both H. pylori-positive patients, and in H. pylori-naïve patients, the debate continues for mechanisms involved in H. pylori-naïve patients.
SUMMARY: The clinical features commonly associated with autoimmune gastritis are increasingly seen in the elderly, irrespective of H. pylori status. Though some patients are genetically predisposed, long-term proton pump inhibitor use increases the prevalence of clinicopathologic features irrespective of genetic tendency.