Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 1;119(5):837-845.
doi: 10.14309/ajg.0000000000002619. Epub 2023 Dec 5.

Long-Term Natural History of Autoimmune Gastritis: Results From a Prospective Monocentric Series

Emanuela Miceli  1 , Marco Vincenzo Lenti  1   2 , Antonella Gentile  2 , Giulia Gambini  3 , Clarissa Petrucci  2 , Lavinia Pitotti  2 , Caterina Mengoli  1 , Michele Di Stefano  1 , Alessandro Vanoli  4 , Ombretta Luinetti  4 , Natascia Brondino  5 , Marco Paulli  4 , Andrea Anderloni  6 , Catherine Klersy  3 , Gino Roberto Corazza  1   2 , Antonio Di Sabatino  1   2
Affiliations

Long-Term Natural History of Autoimmune Gastritis: Results From a Prospective Monocentric Series

Emanuela Miceli et al. Am J Gastroenterol. .

Abstract

Introduction: The natural history of autoimmune gastritis (AIG) has been poorly described. In this study, we report the long-term natural history and clinical clustering of the full spectrum of AIG, from the potential to the complicated stage.

Methods: Prospective single-center study conducted in a tertiary referral center. Patients with AIG at any stage (0 = potential; 1 = early; 2 = florid; 3 = severe; and 4 = complicated) were enrolled (January 2000-December 2022). The histopathological evolution, the clinical presentation, and the correlates of evolution of potential AIG were assessed.

Results: Four hundred ninety-eight patients with AIG (mean age 56.7 ± 15.2 years, F:M ratio 2.5:1) were included, of whom 93 experienced potential AIG. The maximum disease duration was 27 years (median 18, interquartile range 14-23), while the overall median follow-up was 52 months (interquartile range 12-95). Age was significantly lower in stage 0 compared with that in the other stages. Accidental histologic evidence and hematologic findings were the most common clusters of diagnosis. The overall median rate of progression was 7.29 per 100 persons/yr (95% confidence interval [CI] 6.19-8.59), while the stage-specific rates of progression were 10.85 (stage 0; 95% CI 7.75-15.18), 14.83 (stages 1-2; 95% CI 11.89-18.49), and 2.68 (stage 3; 95% CI 1.88-3.84). Newly onset neoplastic complications at follow-up occurred in 41/483 patients (8.5%; 23 neuroendocrine tumors and 18 epithelial dysplasia). No cases of adenocarcinoma were noticed. Male sex was associated with a greater likelihood of evolving from potential AIG to overt AIG.

Discussion: AIG is a progressive disorder, with a virtually absent risk of gastric adenocarcinoma. Patients with potential AIG should be monitored because they carry a high risk of evolving into overt AIG.

PubMed Disclaimer

Comment in

References

    1. Neumann WL, Coss E, Rugge M, et al. Autoimmune atrophic gastritis--pathogenesis, pathology and management. Nat Rev Gastroenterol Hepatol 2013;10(9):529–41.
    1. Lenti MV, Rugge M, Lahner E, et al. Autoimmune gastritis. Nat Rev Dis Primers 2020;6(1):56.
    1. Lenti MV, Facciotti F, Miceli E, et al. Mucosal overexpression of thymic stromal lymphopoietin and proinflammatory cytokines in patients with autoimmune atrophic gastritis. Clin Transl Gastroenterol 2022;13(7):e00510.
    1. Green R, Allen LH, Bjørke-Monsen AL, et al. Vitamin B12 deficiency. Nat Rev Dis Primers 2017;3:17040.
    1. Lenti MV, Miceli E, Cococcia S, et al. Determinants of diagnostic delay in autoimmune atrophic gastritis. Aliment Pharmacol Ther 2019;50(2):167–75.

LinkOut - more resources