The following is a summary of “Distinguishing Features of Autoimmune Gastritis Depending on Previous Helicobacter pylori Infection or Positivity to Anti-Parietal Cell Antibodies: Results From the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO),” published in the December 2024 issue of Gastroenterology by Lenti et al.
Autoimmune gastritis (AIG) is a chronic condition associated with autoimmune diseases. Clinical features and the risk of gastric tumors can vary based on Helicobacter pylori (H. pylori) exposure and the presence of anti-parietal cell antibodies (PCA).
Researchers conducted a retrospective study to describe the clinical features and the risk of gastric tumors in people with AIG.
They involved data from 1,598 people with histologically confirmed AIG from 8 Italian referral centers. Differences were compared between individuals exposed to H. pylori vs. those not exposed and between those positive or negative for PCA, focusing on the incidence of gastric adenocarcinoma and type 1 gastric neuroendocrine neoplasm (gNEN).
The results showed that people who were H. pylori-naive were more likely to have a family history of AIG (14.7% vs. 8.9%; P=0.012), type 1 diabetes (4.9% vs. 2.3%; P=0.025), and pernicious anemia (30.9% vs. 21.1%; P=0.003). People who tested positive for PCA had a higher rate of associated autoimmune diseases (59.0% vs. 42.9%; P<0.001) and were more likely to be diagnosed through case-finding (15.3% vs. 2.6%; P<0.001),15 cases (0.9%) of gastric adenocarcinoma and 153 cases (9.6%) of gNEN, with rates of 0.12 (95% CI 0.07–0.20) and 1.22 (95% CI 1.03–1.42) per 100 person-years, respectively. A vitamin B12/iron deficiency at the time of AIG diagnosis was associated with a 16.44 (95% CI 9.94–27.20; P<0.001) increased risk of gNEN.
They concluded that AIG showed distinct features based on exposure to H. pylori and PCA status. While the risk of gastric adenocarcinoma is low, people with vitamin B12 deficiency at diagnosis may need more frequent endoscopic follow-up to detect gNEN early.
Source: journals.lww.com/ajg/abstract/2024/12000/distinguishing_features_of_autoimmune_gastritis.18.aspx
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