1. Distinguishing features of autoimmune gastritis depending on previous H. pylori infection or positivity to anti-parietal cell antibodies: Results from the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO)
- Author
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Lenti, M, Miceli, E, Lahner, E, Natalello, G, Massironi, S, Schiepatti, A, Zingone, F, Sciola, V, Rossi, R, Cannizzaro, R, De Giorgi, E, Gregorio, V, Fazzino, E, Gentile, A, Petrucci, C, Dilaghi, E, Pivetta, G, Vanoli, A, Luinetti, O, Paulli, M, Anderloni, A, Vecchi, M, Biagi, F, Repici, A, Savarino, E, Joudaki, S, Delliponti, M, Pasini, A, Facciotti, F, Farinati, F, D'Elios, M, Della Bella, C, Annibale, B, Klersy, C, Corazza, G, Di Sabatino, A, Lenti M. V., Miceli E., Lahner E., Natalello G., Massironi S., Schiepatti A., Zingone F., Sciola V., Rossi R. E., Cannizzaro R., De Giorgi E. M., Gregorio V., Fazzino E., Gentile A., Petrucci C., Dilaghi E., Pivetta G., Vanoli A., Luinetti O., Paulli M., Anderloni A., Vecchi M., Biagi F., Repici A., Savarino E. V., Joudaki S., Delliponti M., Pasini A., Facciotti F., Farinati F., D'Elios M. M., Della Bella C., Annibale B., Klersy C., Corazza G. R., Di Sabatino A., Lenti, M, Miceli, E, Lahner, E, Natalello, G, Massironi, S, Schiepatti, A, Zingone, F, Sciola, V, Rossi, R, Cannizzaro, R, De Giorgi, E, Gregorio, V, Fazzino, E, Gentile, A, Petrucci, C, Dilaghi, E, Pivetta, G, Vanoli, A, Luinetti, O, Paulli, M, Anderloni, A, Vecchi, M, Biagi, F, Repici, A, Savarino, E, Joudaki, S, Delliponti, M, Pasini, A, Facciotti, F, Farinati, F, D'Elios, M, Della Bella, C, Annibale, B, Klersy, C, Corazza, G, Di Sabatino, A, Lenti M. V., Miceli E., Lahner E., Natalello G., Massironi S., Schiepatti A., Zingone F., Sciola V., Rossi R. E., Cannizzaro R., De Giorgi E. M., Gregorio V., Fazzino E., Gentile A., Petrucci C., Dilaghi E., Pivetta G., Vanoli A., Luinetti O., Paulli M., Anderloni A., Vecchi M., Biagi F., Repici A., Savarino E. V., Joudaki S., Delliponti M., Pasini A., Facciotti F., Farinati F., D'Elios M. M., Della Bella C., Annibale B., Klersy C., Corazza G. R., and Di Sabatino A.
- Abstract
Objectives:To describe the clinical features and the risk of developing gastric tumors in patients with autoimmune gastritis (AIG).Methods:This was a retrospective, longitudinal, multicenter study conducted at eight Italian tertiary referral centers. We retrieved clinical data from all histologically proven AIG patients. Differences between H. pylori-exposed vs H. pylori-naïve, and anti-parietal cell antibody (PCA)-positive vs PCA-negative patients were investigated. The rate of gastric adenocarcinoma and type 1 gastric neuroendocrine neoplasm (gNEN) was assessed. A multivariable model for factors associated to gNEN was fitted.Results:1598 patients with AIG (median age 58 years, IQR 46-68; F:M ratio 2.7:1) were included. H. pylori-naïve patients were more likely to have a first-degree family history of AIG (14.7% vs 8.9%; p=0.012), type 1 diabetes mellitus (4.9% vs 2.3%; p=0.025), and pernicious anemia (30.9% vs 21.1%; p=0.003). PCA-positive patients had significantly more associated autoimmune diseases (59.0% vs 42.9%; p<0.001) and were more likely to have been diagnosed by a case-finding strategy (15.3% vs 2.6%; p<0.001). Overall, 15 cases (0.9%) of gastric adenocarcinoma and 153 cases (9.6%) of gNEN occurred, with a global rate of 0.12 (95% CI 0.07-0.20) and 1.22 (95% CI 1.03-1.42) per 100 person/year, respectively. Having a vitamin B12/iron deficiency manifestation at AIG diagnosis was associated with an 16.44 (95% CI 9.94-27.20 p<0.001) hazard ratio of gNEN.Conclusions:The "pure"AIG pattern has typical features of an autoimmune disease and seems to be unrelated to H. pylori. In a tertiary referral setting, the risk of developing overt gastric adenocarcinoma is low, while patients with vitamin B12 deficiency complications at onset may benefit from a more intense endoscopic follow-up for early gNEN detection.
- Published
- 2024