Stolte M, Meier E, Meining A
Institut für Pathologie, Klinikum Bayreuth.
Z Gastroenterol. 1998 Aug;36(8):641-3.
More recent investigations have shown that in some patients Helicobacter pylori (Hp) antibodies can act as antigastric antibodies and lead to atrophic autoimmune gastritis of the oxyntic mucosa. The question thus arises as to whether this form of autoimmune gastritis can be healed by eradicating Hp.
Case history of a 21-year-old man with active autoimmune gastritis of the oxyntic mucosa with lymphocytic infiltration of the entire lamina propria, foci of lymphocytic destruction of a number of glands, and hypertrophy of the preserved parietal cells, but no signs of Hp in the Warthin Starry stain. The search for parietal cell antibodies and intrinsic factor antibodies proved negative, while the level of the gastrin in the serum was slightly elevated. Since the presence of Hp IgG antibodies (243 U/ml) was confirmed. Hp eradication therapy was carried out.
15 months after Hp treatment the Hp IgG antibody titre had decreased to 11 U/ml. The autoimmune gastritis had healed, and autoaggressive inflammatory infiltrates with focal destruction of corpus glands and hypertrophy of the parietal cells were no longer detectable.
Autoimmune gastritis induced by Hp may possibly be cured with Hp eradication treatment; to confirm this, further controlled prospective studies are needed.
最近的研究表明，在一些患者中，幽门螺杆菌（Hp）抗体可作为抗胃抗体，导致胃体黏膜萎缩性自身免疫性胃炎。因此，问题就出现了，即这种自身免疫性胃炎是否可以通过根除Hp来治愈。
一名21岁男性的病史，其患有活动性胃体黏膜自身免疫性胃炎，固有层全层淋巴细胞浸润，多个腺体有淋巴细胞破坏灶，残存壁细胞肥大，但沃-施（Warthin Starry）染色未发现Hp迹象。检测壁细胞抗体和内因子抗体均为阴性，而血清胃泌素水平略有升高。由于确认存在Hp IgG抗体（243 U/ml），遂进行了Hp根除治疗。
Hp治疗15个月后，Hp IgG抗体滴度降至11 U/ml。自身免疫性胃炎已治愈，不再能检测到伴有胃体腺体局灶性破坏和壁细胞肥大的自身攻击性炎性浸润。
由Hp诱导的自身免疫性胃炎可能通过根除Hp治疗得以治愈；为证实这一点，需要进一步的对照前瞻性研究。
