Abstract Gastric polyps are often present in the setting of atrophic gastritis. Although the majority of these polyps are nonneoplastic, such as hyperplastic polyps, neoplastic polyps may be present. [ncbi.nlm.nih.gov]

Case Report A 24-year-old male patient presented with a history of lethargy and easy fatigability for about four months. [casereports.in]

The present study is the first study to evaluate the ability of PG test to screen candidates of AIG. Using Miki’s criteria, 3 + PG test showed high sensitivity and specificity in the present study (Table 3). [bmcgastroenterol.biomedcentral.com]

• Fatigue

  There was symptomatic improvement in her signs of fatigue. [ncbi.nlm.nih.gov]

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 31, 2019 [patientslikeme.com]

  Symptoms such as fatigue, hair loss and restless legs syndrome decrease quality of life; furthermore it results in impaired physical and cognitive development and poor pregnancy outcome. [thieme-connect.com]

  Symptoms of PA are anaemia, fatigue, light-headedness and tachycardia. Moreover, the vitamin B12 deficiency hinders DNA synthesis, which causes megaloblasts to be formed in the bone marrow and the gastrointestinal epithelium. [euroimmun.ch]

• Diarrhea

  Histamine excess can cause diarrhea as can bacterial overgrowth or LC. We present a 57-year-old woman with diarrhea, sporadic epigastric pain, and bloating. [ncbi.nlm.nih.gov]

  The presence and the frequency of GI symptoms (heartburn, regurgitation, early satiety, nausea, vomiting, postprandial fullness, epigastric pain, abdominal pain, constipation, diarrhea, and bloating) were assessed at the time of the first visit through [journals.lww.com]

• Delayed Gastric Emptying

  OBJECTIVES: Patients with autoimmune gastritis may have symptoms suggestive of delayed gastric emptying. [ncbi.nlm.nih.gov]

  gastric emptying due to achlorhydria Diagnosis Relies on combination of clinical, serologic and histopathologic findings Presence of consistent serologic findings are not necessary diagnostic criteria if there are typical histologic lesions; autoantibodies [pathologyoutlines.com]

  gastric emptying (80%), reflux symptoms (25%), peripheral neuropathy (25% cases), autonomic abnormalities, and memory loss, are less common and occur in 1%–2% of cases. [en.wikipedia.org]

• Tachycardia

  Symptoms of PA are anaemia, fatigue, light-headedness and tachycardia. Moreover, the vitamin B12 deficiency hinders DNA synthesis, which causes megaloblasts to be formed in the bone marrow and the gastrointestinal epithelium. [euroimmun.ch]

  Anemia (irrespective of etiology) results in shortness of breath, dizziness, tachycardia, lightheadedness, and decreased cognitive and physical function. In pregnancy it can lead to poor pregnancy outcome with early birth and underweight newborns. [ncbi.nlm.nih.gov]

• Paresthesia

  Autoimmune atrophic gastritis is characterized by megaloblastic anemia, anorexia with weight loss, neurologic changes such as numbness and paresthesias. [patientslikeme.com]

  which is characterized by the following symptoms: Weakness Trouble concentrating Shortness of breath Leg cramps Headache Heart palpitations Insomnia Paleness In severe cases, severe B12 deficiency, which is characterized by the following symptoms: Paresthesia [beyondtype1.org]

  […] risk of gastric cancers References:[1][3] Clinical features Intensity of symptoms may be inconsistent and vary widely Hematemesis; (coffee-ground appearance or bright red in color), possibly melena Epigastric pain is possible Nausea, vomiting Abdominal paresthesia [amboss.com]

  […] spasticity (hyperreflexia) Positive Romberg sign Lhermitte’s sign Segmental cutaneous sensory level Autonomic nervous system Postural hypotension Incontinence Impotence Peripheral nervous system Cutaneous sensory loss Hyporeflexia symmetric weakness Paresthesias [wjgnet.com]

• Dizziness

  […] and vomiting loss of appetite unexpected weight loss stomach ulcers iron deficiency anemia (a low level of healthy red blood cells) Autoimmune AG may lead to a B-12 deficiency, which can cause symptoms of anemia, including: weakness lightheadedness dizziness [healthline.com]

  Symptoms include: pain in the chest general fatigue tinnitus or ringing in the ears dizziness lightheadedness heart palpitations A vitamin B-12 deficiency can, in some cases, result in nerve damage. [medicalnewstoday.com]

  Anemia (irrespective of etiology) results in shortness of breath, dizziness, tachycardia, lightheadedness, and decreased cognitive and physical function. In pregnancy it can lead to poor pregnancy outcome with early birth and underweight newborns. [ncbi.nlm.nih.gov]

  The following is a list of type A atrophic gastritis symptoms: Intense chest pains Lightheadedness and dizziness Heart palpitations Ringing in the ears known as tinnitus Physical weakness B12 deficiency, which comes with its own unique list of symptoms [belmarrahealth.com]

• Ataxia

  […] symptoms, patients who developed vitamin B12 deficiency will suffer from gastrointestinal and neurological complaints such as malabsorption, diarrhea, weight loss, glossitis, peripheral numbness, paresthesia with subsequent development of weakness, and ataxia [ncbi.nlm.nih.gov]

• Forgetful

  Furthermore, mental disturbances ranging from forgetfulness to psychosis may arise. Untreated pernicious anemia is fatal [11]. [ncbi.nlm.nih.gov]

From our clinical observations we hypothesize that other GI causes such as autoimmune gastritis (AG) are far more common and non-invasive evaluation should be included in the primary workup. [thieme-connect.com]

Discussion and Conclusions In the cases reported here, AIG was a late and unexpected discovery in the diagnostic workup of a refractory anemia. [frontiersin.org]

Cases and Review. ( 29765934 ) Saglietti C...Sempoux C 2018 6 Deficiency of micronutrients in patients affected by chronic atrophic autoimmune gastritis: A single-institution observational study. ( 30236765 ) Zilli A...Massironi S 2018 7 Iron deficiency workup [malacards.org]

Laboratory workup All patients had a complete blood count, serum iron, total iron-binding capacity (TIBC), serum ferritin, serum B 12 and folate, sedimentation rate, fibrinogen, and CRP studies performed. [bloodjournal.org]

• Macrocytic Anemia

  It is closely associated with pernicious anemia. General Pathology: loss of parietal cells, gastric atrophy. Lab: classically considered to have macrocytic anemia; however, normocytic and microcystic more common.[2] Etiology: autoimmune. [librepathology.org]

  B12 deficiency macrocytic anemia (60.2%), clinical conditions that are correlated to AIG [3]. [hindawi.com]

  Pernicious anemia (PA), the macrocytic anemia also termed as Biermers disease or Addisonian anemia is an autoimmune disorder. [casereports.in]

• Microcytic Anemia

  The proportion of patients with atrophic gastritis was 9 (69%) of 13 in patients with macrocytic anemia and 13 (41%) of 32 in those with microcytic anemia. [bloodjournal.org]

  […] gastrin levels represented the most reliable tool in the diagnosis of ABG; and the presence of anemia, even microcytic, was suggestive of undiagnosed ABG. [jamanetwork.com]

  In effect, both of our patients had a history of menorrhagia, which could have contributed to their anemia (5). The study of Hershko et al. has also shown a high prevalence of H. pylori positivity in young patients with AIG and microcytic anemia. [frontiersin.org]

  In the 14 patients with positivity for both PCA and IFA, microcytic anemia was present in 4 cases (28.6%) and macrocytic anemia in 10 cases (71.4%). [hindawi.com]

  (macrocytic anemia) Iron deficiency anemia (microcytic anemia) Case reports 3 year old boy with immune dysregulation, polyendocrinopathy, enteropathy, X linked (IPEX) syndrome (BMC Pediatr 2018;18:191) 12 and 17 year old girls with iron deficiency anemia [pathologyoutlines.com]

• Abnormal Renal Function

  Because patients who have renal dysfunction shows elevated serum gastrin and pepsinogens [14, 15], we excluded patients with abnormal renal function tests. [bmcgastroenterol.biomedcentral.com]

• Poikilocytosis

  Peripheral blood smear showed erythropenia, macrocytic normochromic red blood cells, moderate aniso-poikilocytosis with good number of macro-ovalocytes, leucocytopenia and mild thrombocytopenia, features consistent with pancytopenia and macrocytic anemia [casereports.in]

• Gastrin Decreased

  Decreased pepsinogen I (decreased pepsinogen I/pepsinogen II ratio) due to loss of zymogenic chief and mucous neck cells from oxyntic mucosa, while antral glands sustain pepsinogen II secretion APC antibodies: serum level correlates with inflammatory [pathologyoutlines.com]

• Hepatocellular Carcinoma

  For example, the concentration of chromogranin A can increase in patients with inflammatory bowel disease, hepatocellular carcinoma, non-alcoholic fatty liver disease, renal failure, and long-term use of proton pump inhibitors [17][18]. [encyclopedia.pub]

RESULTS: After 1 and 3 months of treatment, mean hemoglobin in group A increased from 9.5 +/- 1.2 to 11.2 +/- 1.3 and 12.8 +/- 1.3 g/dl, respectively. [ncbi.nlm.nih.gov]

Stolte M, Bethke B: Elimination of Helicobacter pylori under treatment with omeprazole. Z Gastroenterol 1990;28:271–274. [karger.com]

Conference: 13th Annual ENETS conference (2016) Category: Epidemiology/Natural history/Prognosis - Descriptive epidemiology Presenting Author: dr Sara Massironi Authors: #1339 Netazepide, a Gastrin/CCK2 Receptor Antagonist, Can Eradicate Gastric Neuroendocrine [enets.org]

Rappel S et al: [Carcinoid tumors of the stomach in atrophic autoimmune gastritis: classification, differential diagnosis and prognosis.] Verh Dtsch Ges Pathol. 80:199-207, 1996. [humpath.com]

[…] the cord gastric carcinoid tumors 4,5 Fluoroscopy Upper gastrointestinal fluoroscopic studies are non-specific but may demonstrate 1,2 : decreased/absent fundal folds narrow tubular stomach (fundal diameter small/absent areae gastricae Treatment and prognosis [radiopaedia.org]

Typically, these tumors have a good prognosis, with a five-year survival in more than 95% of patients. [encyclopedia.pub]

These differ in their topographical distribution in the stomach, histologic features, and etiology. [mayoclinic.pure.elsevier.com]

This presentation may be more common than is presently recognized because biopsies of the polyps alone will not show histologic features of atrophic gastritis or reveal the etiology of the polyp itself. [ncbi.nlm.nih.gov]

Therapeutic emphasis depends on the underlying etiology: substitution of vitamin B12 (AMAG) or H. pylori eradication therapy (helicobacter-associated atrophic gastritis). [amboss.com]

Abstract Western countries are seeing a constant decline in the incidence of Helicobacter pylori-associated gastritis, coupled with a rising epidemiological and clinical impact of autoimmune gastritis. [ncbi.nlm.nih.gov]

Conference: 13th Annual ENETS conference (2016) Category: Epidemiology/Natural history/Prognosis - Descriptive epidemiology Presenting Author: dr Sara Massironi Authors: #1339 Netazepide, a Gastrin/CCK2 Receptor Antagonist, Can Eradicate Gastric Neuroendocrine [enets.org]

Epidemiology of Helicobacter pylori infection. Helicobacter 13 (Suppl. 1), 1–6 (2008). 10. Malaty, H. M. Epidemiology of Helicobacter pylori infection. Best Pract. Res. Clin. Gastroenterol. 21, 205–214 (2007). 11. Graham, D. Y. [nature.com]

A marked increase in fundic mucosal histidine decarboxylase activity as well as hypergastrinemia appears to be the pathophysiologic response to achlorhydria caused by autoimmunity against gastric H+,K(+)-ATPase. [ncbi.nlm.nih.gov]

[…] with other autoimmune diseases (e.g., autoimmune thyroiditis) EMAG Helicobacter pylori infection (most important risk factor of atrophic gastritis overall) Dietary factors (e.g., N-nitroso compounds, alcohol intake, high salt intake) References:[1][3] Pathophysiology [amboss.com]

[…] autoimmune disease and other polyglandular autoimmune syndromes Sites Atrophic and metaplastic changes restricted to oxyntic mucosa in gastric body and fundus Gastric antrum may demonstrate reactive gastropathy-like features but is not overtly inflamed Pathophysiology [pathologyoutlines.com]

[citation needed] Pathophysiology[edit] Atrophic gastritis under low power. H&E stain. [en.wikipedia.org]

Duodenal implications in the pathophysiology of functional dyspepsia. J Neurogastroenterol Motil. 16, 251-257. Tack, J, Caenepeel, P, Arts, J, Lee, KJ, Sifrim, D, and Janssens, J (2005). [jnmjournal.org]

The standardization of autoimmune gastritis histology reports and classifications in diagnostic practice is a prerequisite for implementing definitive secondary prevention strategies based on multidisciplinary diagnostic approaches integrating endoscopy [ncbi.nlm.nih.gov]

They may require B-12 injections to help prevent complications. [medicalnewstoday.com]

[…] binding of intrinsic factor to Vitamin B12 Type 2 antibody reacts with free or complexed Vitamin B12 to prevent its biological activity Microscopic (histologic) description Glandular atrophy predominantly in gastric body / fundus with deep or diffuse [pathologyoutlines.com]