Clinical, Endoscopic and Morphological Signs of Chronic Autoimmune Gastritis Taking into Account the Status of Helicobacter pylori

Aim – to study was to identify the most informative diagnostic signs of autoimmune inflammation depending on the status of H. pylori infection. Material and methods. An open cross-sectional cohort study was conducted with the 124 subjects with chronic gastritis (CG) aged 18 to 75 years (median age 56 y.o. [47.5; 65]). The study group included 35 patients with autoimmune gastritis (AIG), median age 54 [43; 61] years. Comparison group 1 included 38 patients with H. pylori-associated and autoimmune gastritis, median age 56 [49; 63] years. Comparison group 2 consisted of 51 patients with H. pylori-associated gastritis, median age 58 [48; 64] years. Analysis of the severity and incidence of gastrointestinal symptoms in patients was performed using the GSRS questionnaire at the onset of the disease and at the time of inclusion in the study. The prevalence and intensity of manifestations of anemic, sideropenic syndromes, vitamin B12 deficiency were assessed. Information on the presence of concomitant autoimmune diseases, iron deficiency and B12 deficiency anemia was necessarily clarified. The results of laboratory studies, endoscopic and morphological examination of gastrobiopsies of the gastric mucosa (GM) with sampling according to the OLGA system were analyzed. Results. The most informative diagnostic signs of AIG in patients with different status of H. pylori infection were identified: the presence of dyspepsia symptoms such as postprandial distress syndrome, as well as manifestations of vitamin B12 deficiency, anemic and sideropenic syndromes, comorbidity with autoimmune thyroiditis, the presence of endoscopic and morphological signs of atrophy and intestinal metaplasia of the GM with mandatory involvement of the body of the stomach. In patients with AIG and the absence of H. pylori infection in the anamnesis, it is possible to identify signs of inflammation and atrophy of the antral GM due to modulation of the gastric microbiota against the background of hypochlorhydria. Conclusion. The results of the study identified the most significant diagnostic signs of AIG in individuals with different H. pylori infection status, which can help the clinician to promptly recognize autoimmune inflammation in the GM. The presence of signs of atrophic changes in the antrum of the stomach in patients with AIG and a negative H. pylori status requires further study.