自身免疫性萎缩性胃炎诊断策略的验证：一例病例报告。
Validation of diagnostic strategies of autoimmune atrophic gastritis: A case report.
作者信息
Sun Wen-Jing, Ma Qiang, Liang Ren-Zheng, Ran Ya-Mei, Zhang Li, Xiao Juan, Peng Yong-Mei, Zhan Bin
机构信息
Department of Gastroenterology, Hepatology and Endocrinology, Thirteenth Peoples' Hospital of Chongqing, Chongqing 400053, China.
Department of Pathology, Daping Hospital, Army Medical University, Chongqing 400042, China.
出版信息
World J Clin Cases. 2021 Nov 6;9(31):9557-9563. doi: 10.12998/wjcc.v9.i31.9557.
BACKGROUND
Autoimmune atrophic gastritis (AAG) is a type of chronic gastritis that mainly affects the gastric corpus. Due to the lack of standard diagnostic criteria and overlaps with the courses of -related atrophic gastritis, reports on the diagnostic strategy of AAG at an early stage are limited.
CASE SUMMARY
A 71-year-old woman with severe anemia was diagnosed with AAG. Endoscopic views and pathological findings showed the coexistence of normal mucosa in the gastric antrum and atrophic mucosa in the gastric fundus. Serological tests showed that anti-parietal cell antibodies and anti-intrinsic factor antibodies were both positive. Immunohistochemical results, which showed negative H-K ATPase antibody staining and positive chromogranin A (CgA) staining, confirmed the mechanism of this disease. After vitamin B12 and folic acid supplementation, the patient recovered well.
CONCLUSION
Successful diagnosis of AAG includes serological tests, endoscopic characteristics, and immunohistochemistry for H-K ATPase and CgA antibodies.
背景
自身免疫性萎缩性胃炎（AAG）是一种主要累及胃体的慢性胃炎。由于缺乏标准诊断标准且与相关萎缩性胃炎病程存在重叠，关于AAG早期诊断策略的报道有限。
病例摘要
一名71岁重度贫血女性被诊断为AAG。内镜检查和病理结果显示胃窦正常黏膜与胃底萎缩性黏膜并存。血清学检查显示抗壁细胞抗体和抗内因子抗体均为阳性。免疫组化结果显示H-K ATP酶抗体染色阴性、嗜铬粒蛋白A（CgA）染色阳性，证实了该病的发病机制。补充维生素B12和叶酸后，患者恢复良好。
结论
AAG的成功诊断包括血清学检查、内镜特征以及H-K ATP酶和CgA抗体的免疫组化检查。
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