Autoimmune Atrophic Gastritis
Definition
- Atrophic gastritis accompanied by anti-parietal cell and anti-intrinsic factor antibodies
Alternate / Historical Names
- Autoimmune metaplastic atrophic gastritis
- Type A gastritis
Diagnostic Criteria
- Requires a biopsy from the body for diagnosis
- Atrophic gastritis largely restricted to the gastric body
- Antrum usually normal but may show focal inflammation and atrophy
- During active phase, there is a lymphocytic and plasma cell infiltrate
- Centered in the deep lamina propria of the body
- Typically sparse in cases with advanced atrophy
- In chronic phase, there is markedly thinned mucosa composed largely of foveolae
- Atrophy of oxyntic glands
- Destruction and loss of both parietal and chief cells
- Usually extensive but need not be complete
- Results in pseudopyloric metaplasia
- Intestinal metaplasia is usually extensive
- Gastric endocrine cell proliferations frequently associated
- Occurs in body, not in antrum
- May begin early in disease
- (G cell hyperplasia occurs in antrum)
- (There are no G cells in the body)
- Anti-parietal cell and anti-intrinsic factor antibodies
- Pernicious anemia may develop in longstanding cases
- May take years for body stores of vitamin B12 to be depleted
- Pernicious anemia may develop in longstanding cases
- Low prevalence of Helicobacter
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : September 9, 2009
