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Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the presence of atrophy in the oxyntic mucosa and a spared antrum, frequently with presence of anti-parietal cells antibodies (APCA). The prevalence of AAG has been estimated at between 0.3% and 2.7% in the general population. AAG can be associated with other autoimmune disorders such as type I diabetes, thyroid disease, vitiligo and alopecia. In literature there are only a few case reports showing the association between AAG and autoimmune liver diseases (primary biliary cholangitis=PBC, primary sclerosant cholangitis=PSC, and autoimmune hepatitis=AIE) The aim of this study was to evaluate the prevalence of AAG in patients affected by autoimmune liver diseases (PBC, PSC and AIE). We conducted a prospective study in a cohort of 46 patients with a diagnosis of either PBC (26/46, 56.5%), PSC (1/46, 2.1%), AIE (11/46, 23.9%), or an overlap PBC/AIE (8/46, 17.3%) who underwent, according to our prescription, gastroscopy (EGDS) for different reasons (dyspepsia, anemia, diarrhea, reflux symptoms or search for esophageal varices). Biopsies during EGDS were taken following the updated Sydney System protocol. 45/46 (97.8%) patients were female, while only 1 patient (2.1%) was male. Nine (19.5%) out of 46 patients were diagnosed with AAG, with histological evidence of atrophy in the oxyntic mucosa only. Moreover, 7 of these patients had positive APCA, while in the other 2 patients APCA were not tested. Six of these 9 patients were affected by PBC, 2 had AIE and 1 had an overlap syndrome (PBC/AIE). In addition, 23/46 (50%) patients had other autoimmune disorders. Our study showed a strong association between AAG and autoimmune liver diseases raising the question of the need of gastroscopy with adequate biopsy sampling and/or serological assay of APCA in patients diagnosed with liver autoimmune diseases to screen for AAG. [ABSTRACT FROM AUTHOR]

This article presents the findings of a multi-center study conducted in Italy that aimed to assess the frequency of type I gastric neuroendocrine neoplasms (gNENs) in patients with autoimmune atrophic gastritis (AAG). The study included 375 patients with AAG, and over a median follow-up of 4 years, 80 patients were found to have 97 well-differentiated gNENs. The study highlights the importance of regular endoscopic surveillance and thorough histopathological examination in patients with AAG for early diagnosis and treatment of gNENs. The occurrence of gNENs in patients with AAG is linked to elevated circulating gastrin levels, which stimulate abnormal proliferation of gastric enterochromaffin-like cells. [Extracted from the article]

This article, published in the journal Endoscopy, discusses the use of virtual chromoendoscopy (CE) to detect Helicobacter pylori (Hp) infection and predict gastric preneoplastic conditions. The study, conducted in a Western country, focused on evaluating antrum mucosal patterns (MPs) on CE and their association with Hp infection. The results showed that certain MPs were significantly associated with Hp-related gastritis, previous Hp infection, and antrum intestinal metaplasia. The study suggests that CE could be a reliable tool for identifying Hp infection and antrum IM, potentially reducing the need for biopsies and improving Hp detection. [Extracted from the article]

This article presents the findings of a multicentric retrospective study conducted in Italy on patients with autoimmune atrophic gastritis (AAG). The study aimed to investigate the incidence and characteristics of gastric polyps in patients with AAG. The study included 375 patients with AAG, and it was found that 50.4% of these patients had at least one incidental polyp. The polyps observed included inflammatory, adenomatous, fundic gland polyps, gastric neuroendocrine tumors (gNETs), adenocarcinomas, and one MALT lymphoma. The study highlights the importance of proactive endoscopic monitoring and comprehensive histopathological evaluation in patients with AAG to effectively identify and manage these different gastric lesions. [Extracted from the article]

Background: Seroepidemiological and clinical studies suggest that Helicobacter pylori may cause iron deficiency anaemia (IDA) in the absence of peptic lesions by undefined mechanisms, which still remain to be fully [...]

This article, published in the journal Endoscopy, examines the clinical presentation and endoscopic-histological features of patients with eosinophilic esophagitis (EoE) who were diagnosed with food impaction (FI) compared to those without FI (NFI). The study found that patients with FI had a less frequent occurrence of gastroesophageal reflux-like symptoms before EoE diagnosis compared to NFI patients. Additionally, FI patients had a higher EREFS score, indicating a more severe disease presentation, and a higher eosinophilic peak. The findings suggest that EoE patients with FI may have a less symptomatic disease course before diagnosis, potentially leading to a delay in diagnosis. [Extracted from the article]

Background. EndoFaster® analyzes gastric juice in real time during gastroscopy allowing the detection of hypo-achlorhydric conditions, like corpus atrophic gastritis. Narrow-band imaging (NBI) endoscopy allows to accurately detect and perform target biopsies in areas of intestinal metaplasia, a histological change often associated to corpus atrophic gastritis. Aims. To compare the diagnostic accuracy of EndoFaster® with histological evaluation for corpus atrophic gastritis through high-resolution (HR) NBI targeted biopsies. Methods. Prospective study on consecutive adult patients undergoing gastroscopy between April and November 2018. Patients in therapy with proton pump inhibitors, previous gastric surgery, and/or known gastric neoplasia were excluded. At the beginning of gastroscopy, gastric juice was aspirated and analyzed by EndoFaster® in 15 seconds. Endoscopists were blinded to the report of EndoFaster®. Evaluation of gastric mucosa in HR-white light was firstly performed, then with HR-NBI allowing to perform targeted biopsies on areas suspected for intestinal metaplasia; otherwise, biopsies were performed according to the updated Sydney System protocol and sent for histopathological evaluation. Results. Overall, 124 patients were included [64% F; 56 (18-85) years]. Corpus atrophic gastritis was present in 41.9% of patients. EndoFaster® showed an accuracy for corpus atrophic gastritis diagnosis, compared to histopathological evaluation as gold standard, of 87.1% and a sensitivity, specificity, PPV, and NPV of 78.8%, 93.1%, 89.1%, and 85.9%, respectively. pH showed a positive correlation with the severity score of atrophy (r = 0.67 , 95% CI: 0.73-0.81, and p < 0.0001). EndoFaster® allowed to diagnose corpus atrophic gastritis in 3.7% of patients negative to NBI (corpus atrophic gastritis without intestinal metaplasia). Conclusion. EndoFaster® seems a promising tool to diagnose corpus atrophic gastritis. The evaluation of hypo-achlorhydria during gastroscopy can address bioptic sampling in corpus atrophic gastritis patients without intestinal metaplasia. [ABSTRACT FROM AUTHOR]

G. Capurso [1] S. Passi [2] G. D'Ambra [1] R. Ricci [2] E. Lahner [1] A. Carnuccio [1] F. Maggio [2] E. Di Giulio [1] G. Delle Fave [1] B. [...]

E. Lahner [1] C. Grossi [1] P. Caruana [2] R. Negrini [3] G. Capurso [1] C. Bordi [2] G. Delle Fave [1] B. Annibale [1] [7/17] Does Positive Serology indicate [...]

C. Grossi [1] R. Negrini [2] E. Lahner [1] G. Capurso [1] P. Caruana [3] C. Bordi [3] G. Delle Fave [1] B. Annibale [1] [7/10] [*] Relationship between Atrophic [...]