Autoimmune gastritis, with or without pernicious anemia: epidemiology, risk factors, and clinical management

Therap Adv Gastroenterol. 2021 Aug 31:14:17562848211038771. doi: 10.1177/17562848211038771. eCollection 2021.

Abstract

Autoimmune gastritis (AIG) is a chronic immune-mediated, inflammatory condition that involves the destruction of the gastric oxyntic mucosa through the autoimmune-mediated loss of parietal cells, with replacement by atrophic and metaplastic tissue. Diagnosing AIG is important, given the need for ongoing clinical management and vigilance with respect to downstream complications, the most serious of which is gastric adenocarcinoma. Other clinical consequences include gastric neuroendocrine tumors, consequences related to decreased gastric acid and decreased intrinsic factor due to parietal cell destruction and antibodies against intrinsic factor (e.g. micronutrient deficiencies), as well as concomitant autoimmune disorders. Considering the prevalence of AIG and the potential for severe clinical outcomes, it is important to engage in efforts to reduce practice pattern variability related to diagnosis and management. Accordingly, herein, we review of the epidemiology, pathogenesis, clinical presentation of AIG, including both gastric and extragastric manifestations, and provide an overview of clinical management.

Keywords: Helicobacter pylori; atrophic gastritis; carcinoid; gastric neoplasm; intestinal metaplasia; iron deficiency; neuroendocrine tumors; vitamin B12 deficiency.

Publication types

  • Review