Features that aid identification of autoimmune gastritis in a background of active Helicobacter pylori infection Journal Article
| Authors: | Choudhuri, J.; Hall, S.; Castrodad-Rodriguez, C. A.; Westerhoff, M.; El Jabbour, T.; Jain, S.; Panarelli, N. C. |
| Article Title: | Features that aid identification of autoimmune gastritis in a background of active Helicobacter pylori infection |
| Abstract: | Context.--Helicobacter pylori--associated and autoimmune gastritis may coexist in a subset of patients who require treatment for both disorders. Objective.--To delineate findings that identify autoimmune gastritis in the background of H pylori infection. Design.--We examined cases of (1) patients with H pylori--associated gastritis who had successful eradication therapy and subsequent biopsies diagnostic of autoimmune gastritis and (2) H pylori--associated gastritis wherein pathologists noted features of autoimmune gastritis during original interpretation. Control patients underwent H pylori eradication but lacked evidence of autoimmune gastritis or H pylori infection after 10 years of follow-up. Results.--Eight subjects had H pylori--associated gastritis followed by H pylori--negative sampling that showed autoimmune gastritis. Review of original samples showed full-thickness inflammation of oxyntic mucosa in 8 of 8 and oxyntic gland loss in 7 of 8 cases. Enterochromaffin-like (ECL) cell hyperplasia, pyloric metaplasia, and intestinal metaplasia were present in 4 of 8 (80% of 5 tested cases), 4 of 8, and 3 of 8 cases, respectively. Features of autoimmune gastritis were noted at the time of their original H pylori diagnosis in 11 study subjects. Ten of 11 samples displayed full-thickness inflammation of oxyntic mucosa and/or partial loss of oxyntic glands, 8 of 11 had ECL cell hyperplasia (all tested cases), 6 of 11 showed pyloric metaplasia, and 4 of 11 harbored intestinal metaplasia. Except for full-thickness oxyntic mucosa inflammation, these features were absent in control cases. Conclusions.--Full-thickness inflammation combined with oxyntic gland loss and ECL cell hyperplasia may help to identify autoimmune gastritis in patients with concomitant H pylori infection. |
| Keywords: | adult; prospective studies; inflammation; biopsy; helicobacter infections; middle age; retrospective design; case studies; human; male; female; gastritis -- diagnosis; autoimmune diseases -- diagnosis |
| Journal Title: | Archives of Pathology & Laboratory Medicine |
| Volume: | 145 |
| Issue: | 12 |
| ISSN: | 0003-9985 |
| Publisher: | College of American Pathologists |
| Date Published: | 2021-12-01 |
| Start Page: | 1536 |
| End Page: | 1543 |
| Language: | English |
| DOI: | 10.5858/arpa.2020-0615-OA |
| PROVIDER: | EBSCOhost |
| PROVIDER: | cinahl |
| PUBMED: | 33635965 |
| DOI/URL: | |
| Notes: | Accession Number: 153886781 -- Entry Date: 20211207 -- Revision Date: 20211207 -- Publication Type: Article; pictorial; research; tables/charts -- Journal Subset: Allied Health; Biomedical; Peer Reviewed; USA -- NLM UID: 7607091. -- Source: Cinahl |
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