Soykan İrfan, Er Ramazan Erdem, Baykara Yigit, Kalkan Cağdaş
Ankara University Medical School, İbn-i Sina Hospital, Gastroenterology, Ankara, Türkiye.
Department of Pathology, Stanford Medicine, Transfusion Medicine and Blood Banking, Stanford, CA, USA.
Turk J Gastroenterol. 2024 Nov 25;36(3):135-144. doi: 10.5152/tjg.2024.24563.
Autoimmune gastritis is an immune-mediated disease characterized by the destruction of parietal cells and atrophy of the oxyntic mucosa due to anti-parietal cell antibodies. It may lead to serious conditions including iron/vitamin B12 and micronutrient deficiencies, neurological disorders, and gastric malignancies. The exact mechanism of this disease is not exactly understood; however, dysregulated immunological mechanisms appear to be major contributors. Patients with this disease are often asymptomatic but may present with gastrointestinal symptoms and/or iron/vitamin B12 deficiencies. Although important serological markers are available and despite advanced endoscopic techniques, the definitive diagnosis relies on histopathological examination of gastric corporal biopsy specimens. Autoimmune gastritis is closely related with increased risk of gastric neuroendocrine tumors and gastric adenocarcinoma. Patients with autoimmune gastritis do not benefit from specific treatments, thus, management is directed to restore micronutrient deficiencies and to prevent occurrence of neoplastic transformation with appropriate endoscopic surveillance.
自身免疫性胃炎是一种免疫介导的疾病，其特征是由于抗壁细胞抗体导致壁细胞破坏和胃体黏膜萎缩。它可能导致严重情况，包括铁/维生素B12和微量营养素缺乏、神经紊乱以及胃部恶性肿瘤。这种疾病的确切机制尚不完全清楚；然而，免疫调节机制失调似乎是主要原因。患有这种疾病的患者通常没有症状，但可能出现胃肠道症状和/或铁/维生素B12缺乏。尽管有重要的血清学标志物且内镜技术先进，但明确诊断仍依赖于胃体活检标本的组织病理学检查。自身免疫性胃炎与胃神经内分泌肿瘤和胃腺癌的风险增加密切相关。自身免疫性胃炎患者无法从特定治疗中获益，因此，治疗旨在纠正微量营养素缺乏，并通过适当的内镜监测预防肿瘤转化的发生。
