Department of Gastroenterology, Southampton General Hospital, Southampton, UK.
Department of Medicine, Hull University Teaching Hospitals, Hull, UK.
J R Coll Physicians Edinb. 2023 Sep;53(3):176-178. doi: 10.1177/14782715231180965. Epub 2023 Jun 17.
Current guidelines recommend surveillance for gastric adenocarcinoma in patients with extensive chronic atrophic gastritis (CAG), which is considered a premalignant condition. Although the association between vitamin B12 deficiency and CAG is well described, the indication for endoscopic investigation is only advised in patients with pernicious anaemia. Our case did not have evidence of autoimmune or but despite this she had CAG. We suggest considering gastroscopy for severe, unexplained vitamin B12 deficiency, particularly in this patient group.
现行指南建议对广泛慢性萎缩性胃炎(CAG)患者进行胃癌监测,因为 CAG 被认为是一种癌前病变。尽管维生素 B12 缺乏与 CAG 之间的关联已得到充分描述,但仅建议在患有恶性贫血的患者中进行内镜检查。我们的病例没有自身免疫或证据,但尽管如此,她仍患有 CAG。我们建议对于严重的、原因不明的维生素 B12 缺乏症,特别是在这类患者中,考虑进行胃镜检查。