Clinical manifestations of chronic atrophic gastritis: Guidelines, literature review and own observation


DOI: https://dx.doi.org/10.18565/therapy.2023.2.62-71

Luzina E.V., Tomina E.A., Zhigzhitova E.B., Lareva N.V.

Chita State Medical Academy of the Ministry of Healthcare of Russia
Abstract. Atrophic gastritis is defined as the loss of gastric glands, with or without metaplasia, in a setting of chronic inflammation caused by autoimmunity or due to Helicobacter pylori infection. Gastrointestinal manifestations of the disease are nonspecific. The destruction of parietal cells in the stomach determines the decrease or cessation of hydrochloric acid secretion. Under conditions of hypochlorhydria, the absorption of micronutrients is disturbed, which leads to the formation of iron and vitamin B12 deficiency anemia. All patients with atrophic gastritis should be screened for Helicobacter pylori infection. In the case of a negative result, the diagnosis of autoimmune gastritis is necessary. Regardless of the etiology, the diagnosis of atrophic gastritis must be confirmed morphologically with the definition of the stage of the process. Severe atrophy (stage III/IV according to the OLGA system) is a risk factor for the development of gastric adenocarcinoma. Another consequence of atrophy in autoimmune gastritis is the formation of a neuroendocrine tumor. Possible clinical outcomes determine the need for long-term and regular endoscopic and morphological follow-up. Autoimmune gastritis is often combined with other autoimmune diseases, among which thyroid diseases are the most common. The article presents a clinical observation of severe autoimmune atrophic gastritis in a young woman. The main manifestations of the disease were iron, vitamin B12-deficiency anemia and diffuse goiter with thyrotoxicosis, the trigger for the formation of which was a SARS-CoV2 infection. The clinical situation is discussed by hematologist, endocrinologist and gastroenterologist.
Keywords: autoimmune atrophic gastritis, diffuse toxic goiter, Helicobacter pylori, anemia
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About the Autors

Elena V. Luzina, PhD in Medical Science, associate professor of the Department of therapy of the Faculty of additional professional education, Chita State Medical Academy of the Ministry of Healthcare of Russia, Chairman of the Trans-Baikal Scientific Society of Gastroenterologists. Address: 672000, Chita, 5 Kokhanskogo Str. E-mail: el.luz@list.ru. ORCID: https://orcid.org/0000-0002-8282-3056. eLibrary SPIN: 6748-9361
Elena A. Tomina, PhD in Medical Science, associate professor of the Department of therapy of the Faculty of additional professional education, Chita State Medical Academy of the Ministry of Healthcare of Russia. Address: 672000, Chita, 5 Kokhanskogo Str. ORCID: https://orcid.org/0000-0003-2423-666X
Evgenia B. Zhigzhitova, PhD in Medical Science, assistant at the Department of therapy of the Faculty of additional professional education, Chita State Medical Academy of the Ministry of Healthcare of Russia. Address: 672000, Chita, 5 Kokhanskogo Str. ORCID: https://orcid.org/0000-0002-5288-1298
Natalya V. Lareva, MD, professor, vice-rector for scientific and international affairs, head of the Department of therapy of the Faculty of additional professional education, Chita State Medical Academy of the Ministry of Healthcare of Russia, Chairman of the Trans-Baikal Regional Branch of the RSMSIM. Address: 672000, Chita, 5 Kokhanskogo Str. ORCID: https://orcid.org/0000-0001-9498-9216. eLibrary SPIN: 1228-6205


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