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atrophic autoimmune pangastritis

Wednesday 24 January 2007

Atrophic autoimmune pangastritis is a distinctive form of antral and fundic gastritis associated with systemic autoimmune disease.

This gastritis is characterized by intense mucosal inflammation that persists even into the phase of severe glandular atrophy.

This differs from the other two major forms of chronic atrophic gastritis in which the inflammation tends to diminish as the mucosa becomes atrophic.

The stomach shows a pangastritis with diffuse involvement of the body and antrum that is unassociated with either HP infections or the neuroendocrine cell hyperplasia associated with autoimmune gastritis.

Patients range in age from 1 to 75 years and show a slight female predominance.

All patients have systemic autoimmune diseases that include autoimmune enterocolitis, systemic lupus erythematosus, refractory sprue, autoimmune hemolytic anemia, and disabling fibromyalgia.

The mucosal inflammation involves the mucosal thickness with a slight tendency to preferentially affect the deep glands, frequently accompanied by apoptotic bodies in a pattern resembling graft-versus-host disease (GVHD).

Glandular atrophy, lymphoplasmacytic infiltrates, and neutrophilic infiltrates diffusely involve the stomach.

Microabscesses may be present in the gastric glands.

There may also be areas of overt ulceration.

These patients are not hypergastrinemic and do not develop neuroen-docrine cell lesions.

References

- Jevremovic D, Torbenson M, Murray JA, Burgart LJ, Abraham SC. Atrophic autoimmune pangastritis: A distinctive form of antral and fundic gastritis associated with systemic autoimmune disease. Am J Surg Pathol. 2006 Nov;30(11):1412-9. PMID: 17063082