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因复发性胃神经内分泌肿瘤诊断为自身免疫性胃炎:一例报告

Autoimmune gastritis diagnosed due to recurrent gastric neuroendocrine tumor: a case report.

作者信息

Yang Qunying, Jin XiangHong, Lv Xiangyin, Hu JianWen

机构信息

Department of Gastroenterology, Dongyang People's Hospital, Dongyang, China.

出版信息

Front Med (Lausanne). 2025 Jan 3;11:1519819. doi: 10.3389/fmed.2024.1519819. eCollection 2024.

Abstract

As digestive endoscopy becomes more prevalent, an increasing number of autoimmune gastritis (AIG) cases have been diagnosed, which has contributed to a growing body of research on AIG. We report the case of a patient with AIG who was diagnosed due to receiving endoscopic surgery after discovering a gastric neuroendocrine tumor (GNET) during gastroscopy twice within 3 years. The patient was admitted to our hospital for endoscopic submucosal dissection (ESD) due to GNET recurrence discovered during gastroscopy. The patient had previously undergone ESD due to a GNET discovered during gastroscopy 3 years ago. Recent repeat gastroscopy revealed severe mucosal atrophy in the gastric body and fundus, an ulcer in the gastric antral, and two mucosal bulges in the gastric body. Pathology indicated Grade 2 (G2)-GNET, and ESD was performed again. The patient also had iron deficiency anemia and thyroid dysfunction, elevated gastrin, and decreased pepsinogen I (PG I) and PG I/II. Hence, AIG was diagnosed. Recurrent GNET cases, especially those with concurrent anemia and abnormal thyroid function, may experience AIG. In addition to symptomatic treatment, the clinician must evaluate the patient's overall condition.

摘要

随着消化内镜检查的日益普及,自身免疫性胃炎(AIG)的诊断病例越来越多,这也推动了对AIG的研究不断增加。我们报告了一例AIG患者,该患者在3年内两次胃镜检查时发现胃神经内分泌肿瘤(GNET)后接受了内镜手术,从而被诊断为AIG。该患者因胃镜检查发现GNET复发而入院接受内镜黏膜下剥离术(ESD)。患者3年前曾因胃镜检查发现GNET而接受过ESD。近期复查胃镜显示胃体和胃底严重黏膜萎缩,胃窦部溃疡,胃体部有两个黏膜隆起。病理提示2级(G2)-GNET,并再次进行了ESD。该患者还患有缺铁性贫血和甲状腺功能障碍,胃泌素升高,胃蛋白酶原I(PG I)和PG I/II降低。因此,诊断为AIG。复发性GNET病例,尤其是合并贫血和甲状腺功能异常的病例,可能会发生AIG。除了对症治疗外,临床医生还必须评估患者的整体状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/898c/11739283/dbdf37a7440f/fmed-11-1519819-g0001.jpg

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