Department of, Health Care Medicine, Kawasaki Medical School, Okayama, Japan.
Department of Gastroenterology, Fujieda Municipal General Hospital, Shizuoka, Japan.
Dig Endosc. 2022 May;34(4):700-713. doi: 10.1111/den.14175. Epub 2021 Nov 10.
Autoimmune gastritis (AIG) is a special type of chronic gastritis characterized by autoimmune disorders caused by cellular immunity, resulting in the destruction of parietal cells and production of antiparietal cell antibodies. Endoscopic findings of AIG are mainly characterized by corpus-dominant advanced atrophy. The antral area is generally considered to have no or mild atrophy; however, there are cases wherein the gastric mucosa is red or faded due to past infection with Helicobacter pylori or bile reflux. Currently, there are no diagnostic criteria for AIG in Japan, and it is important to make a diagnosis based on the presence of gastric autoantibodies and characteristic endoscopic and histological findings. AIG is associated with gastric cancer, neuroendocrine tumors (NETs), and other autoimmune diseases, such as thyroid diseases, anemia, and neurological symptoms due to impaired absorption of iron and vitamin B , and thus requires systemic treatment. The significance of diagnosing AIG is to include patients as a high-risk group for the development of gastric cancer and gastric NETs, provide an opportunity to detect autoimmune endocrine diseases, and initiate therapeutic intervention before anemia and neurological symptoms develop. It is important to pay close attention to the occurrence of AIG comorbidities not only at the time of AIG diagnosis but also during follow-up after detection.
自身免疫性胃炎（AIG）是一种特殊类型的慢性胃炎，其特征是由细胞免疫引起的自身免疫紊乱，导致壁细胞破坏和产生抗壁细胞抗体。AIG 的内镜表现主要以胃体为主的高级别萎缩为特征。通常认为胃窦区域无或轻度萎缩；然而，由于过去感染幽门螺杆菌或胆汁反流，胃黏膜可能会出现红色或褪色。目前，日本尚无 AIG 的诊断标准，重要的是要根据胃自身抗体和特征性内镜及组织学表现做出诊断。AIG 与胃癌、神经内分泌肿瘤（NET）和其他自身免疫性疾病有关，如甲状腺疾病、贫血和由于铁和维生素 B 吸收不良引起的神经系统症状，因此需要进行系统治疗。诊断 AIG 的意义在于将患者纳入胃癌和胃 NET 发展的高危人群，提供检测自身免疫内分泌疾病的机会，并在贫血和神经系统症状出现之前进行治疗干预。不仅在诊断 AIG 时，而且在检测后随访期间，密切关注 AIG 合并症的发生非常重要。
