Current perspective on the problem of autoimmune gastritis

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Currently, there is an increase in the prevalence of autoimmune diseases. In particular, against the background of a decrease in the incidence of Helicobacter pylori associated gastritis, the number of patients with autoimmune gastritis increases. This is an autoimmune disease in which the destruction of the acid-producing gastric mucosa occurs due to the loss of parietal cells with their replacement by atrophic and metaplastic tissue, which leads to impaired absorption of iron, vitamin B12, deficiency states, anemia, neurological disorders and the development of malignant tumors. It is not fully known what triggers aggression. It is assumed that the autoimmune process can occur due to the interaction of genetic and environmental factors. In addition, the relationship between H. pylori and the development of autoimmune gastritis has not been fully studied.

Diagnosis of autoimmune gastritis is based on serological markers, but its leading method is esophagogastroduodenoscopy with biopsy. Several endoscopic signs allow one to suspect autoimmune gastritis: reverse atrophy; the presence of islets of preserved acid-producing mucosa; viscous mucus; protrusions in the body of the stomach, which are currently called "white spheres"; glomus formations, which are a proliferation of enterochromaffin-like cells. Atrophy of the mucous membrane of the body of the stomach is detected in biopsy material; three stages of inflammation of the mucous membrane of the body of the stomach can also be observed. Patients with autoimmune gastritis have an increased risk of developing malignant neoplasms, namely type 1 neuroendocrine tumors and adenocarcinoma. Therefore, regular monitoring is necessary for the early detection of these pathologies. However, the monitoring intervals have not been definitively determined. Most sources indicate the need for gastroscopy once every 1–3 years.

作者简介

Nikita Shcherbachenya

Pirogov City Clinical Hospital No. 1; DocMed Clinic of Evidence-Based Medicine

编辑信件的主要联系方式.
Email: endoscopy1995@mail.ru
ORCID iD: 0009-0001-7414-3819
俄罗斯联邦, Moscow; Moscow

Konstantin Vasilenko

Pirogov City Clinical Hospital No. 1

Email: kostikva1980@gmail.com
ORCID iD: 0000-0001-6669-7419

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Moscow

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2. Fig. 1. Diffuse atrophy of the gastric body mucosa when examined in inversion (a) and direct projection (b). © Eco-Vector, 2025.

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3. Fig. 2. Endoscopic view of “reverse” atrophy. Atrophic changes mucosa of the body of the stomach with preserved mucosa of the antral section. © Eco-Vector, 2025.

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4. Fig. 3. Endoscopic view of preserved acid-producing areas of the gastric body mucosa. © Eco-Vector, 2025.

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5. Fig. 4. Viscous secretion on the surface of mucosa in autoimmune gastritis. © Eco-Vector, 2025.

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6. Fig. 5. White globe appearance on the surface of mucosa in white light (a) and in narrow-band mode (b). © Eco-Vector, 2025.

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7. Fig. 6. Glomus-like lesions of the stomach (a), glomus-like lesions with white globe appearance and areas of foveolar hyperplasia (b). © Eco-Vector, 2025.

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8. Fig. 7. Picture of “cast-of skin appearance” — reticular capillary network without gland openings. © Eco-Vector, 2025.

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9. Fig. 8. “Circular wrinkled pattern” in the antral part of the stomach. © Eco-Vector, 2025.

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10. Fig. 9. Multiple hyperplastic polyps of the gastric body in autoimmune gastritis. © Eco-Vector, 2025.

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11. Fig. 10. Neuroendocrine tumors of the stomach in LCI (linked color imaging) mode (a, c) and in BLI (blue laser imaging) mode (b). © Eco-Vector, 2025.

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