Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images
Autoimmune gastritis (AIG) is chronic atrophic gastritis caused by an autoimmune mechanism of unknown etiology and presents with various pathological conditions by causing an achlorhydria state through parietal cell damage. The most characteristic endoscopic finding in AIG is advanced corpus-dominan...
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/12/3523 |
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| author | Maiko Kishino Kouichi Nonaka |
| author_facet | Maiko Kishino Kouichi Nonaka |
| author_sort | Maiko Kishino |
| collection | DOAJ |
| description | Autoimmune gastritis (AIG) is chronic atrophic gastritis caused by an autoimmune mechanism of unknown etiology and presents with various pathological conditions by causing an achlorhydria state through parietal cell damage. The most characteristic endoscopic finding in AIG is advanced corpus-dominant mucosal atrophy. A recent study that examined several cases in Japan revealed the presence of endoscopic features other than corpus-dominant advanced atrophy. Remnants of oxyntic mucosa and sticky adherent dense mucus were found in ≥30% of cases, and hyperplastic polyps were found in ≥20% of cases. In image-enhanced endoscopy (IEE), white globe appearance (WGA) was observed in 32% of AIG cases. Additionally, some reports have stated that the findings in AIG cases using IEE showed cast-off skin appearance (CSA) and foveola type mucosa; however, a consensus is yet to be achieved. These endoscopic results were found in cases of advanced-stage AIG. There have been few reports concerning early-stage AIG cases. In these few reports, all of the cases were pathologically diagnosed as early AIG. In all of the cases, the pathological findings almost always showed neither parietal cell destruction nor atrophy. Endoscopic findings such as “mosaic pattern with slight swelling of the areae gastricae”, “diffuse reddened and edematous gastric fundic gland mucosa”, and “pseudopolyp-like nodules” may be common characteristics of early images. In such early cases, high antibody titers, no atrophic changes, and few clinical abnormal findings were shown. Endoscopists are expected to update their knowledge regarding AIG diagnosis with the evolution of imaging equipment. |
| first_indexed | 2024-03-09T23:26:31Z |
| format | Article |
| id | doaj.art-8bfd9c828e05414da712f0b1d226970d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:26:31Z |
| publishDate | 2022-06-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-8bfd9c828e05414da712f0b1d226970d2023-11-23T17:17:25ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011112352310.3390/jcm11123523Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early ImagesMaiko Kishino0Kouichi Nonaka1Department of Digestive Endoscopy, Tokyo Women’s Medical University, Tokyo 162-8666, JapanDepartment of Digestive Endoscopy, Tokyo Women’s Medical University, Tokyo 162-8666, JapanAutoimmune gastritis (AIG) is chronic atrophic gastritis caused by an autoimmune mechanism of unknown etiology and presents with various pathological conditions by causing an achlorhydria state through parietal cell damage. The most characteristic endoscopic finding in AIG is advanced corpus-dominant mucosal atrophy. A recent study that examined several cases in Japan revealed the presence of endoscopic features other than corpus-dominant advanced atrophy. Remnants of oxyntic mucosa and sticky adherent dense mucus were found in ≥30% of cases, and hyperplastic polyps were found in ≥20% of cases. In image-enhanced endoscopy (IEE), white globe appearance (WGA) was observed in 32% of AIG cases. Additionally, some reports have stated that the findings in AIG cases using IEE showed cast-off skin appearance (CSA) and foveola type mucosa; however, a consensus is yet to be achieved. These endoscopic results were found in cases of advanced-stage AIG. There have been few reports concerning early-stage AIG cases. In these few reports, all of the cases were pathologically diagnosed as early AIG. In all of the cases, the pathological findings almost always showed neither parietal cell destruction nor atrophy. Endoscopic findings such as “mosaic pattern with slight swelling of the areae gastricae”, “diffuse reddened and edematous gastric fundic gland mucosa”, and “pseudopolyp-like nodules” may be common characteristics of early images. In such early cases, high antibody titers, no atrophic changes, and few clinical abnormal findings were shown. Endoscopists are expected to update their knowledge regarding AIG diagnosis with the evolution of imaging equipment.https://www.mdpi.com/2077-0383/11/12/3523autoimmune gastritis (AIG)image-enhanced endoscopy (IEE)early stage |
| spellingShingle | Maiko Kishino Kouichi Nonaka Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images Journal of Clinical Medicine autoimmune gastritis (AIG) image-enhanced endoscopy (IEE) early stage |
| title | Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images |
| title_full | Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images |
| title_fullStr | Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images |
| title_full_unstemmed | Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images |
| title_short | Endoscopic Features of Autoimmune Gastritis: Focus on Typical Images and Early Images |
| title_sort | endoscopic features of autoimmune gastritis focus on typical images and early images |
| topic | autoimmune gastritis (AIG) image-enhanced endoscopy (IEE) early stage |
| url | https://www.mdpi.com/2077-0383/11/12/3523 |
| work_keys_str_mv | AT maikokishino endoscopicfeaturesofautoimmunegastritisfocusontypicalimagesandearlyimages AT kouichinonaka endoscopicfeaturesofautoimmunegastritisfocusontypicalimagesandearlyimages |