Dynamic Evolution of Hyperplastic Polyps in the Setting of Autoimmune Gastritis: An In-Depth Interpretation of Gastrin-Driven Patho-mechanisms in a Case

Through longitudinal clinical follow-up of a 75-year-old male with autoimmune gastritis (AIG) complicated by gastric hyperplastic polyps (GHPs), this study systematically investigated the critical regulatory role of gastrin signaling networks in gastric mucosal remodeling. The case demonstrated that within the established pathological cascade of AIG (from parietal cell destruction to gastric acid deficiency and hypergastrinemia), GHPs exhibited short-term volumetric growth. This observation challenges traditional views about the indolent nature of hyperplastic polyps. Our findings highlight the dual role of proton-pump inhibitor (PPI) therapy in AIG management while alleviating mucosal inflammation, it paradoxically induces G-cell hypersensitivity that elevates gastrin levels beyond biological thresholds (332 increasing to 770 U/L), creating a critical driver for GHP progression. This case redefines clinical management paradigms for AIG complications and offers translational insights for gastrointestinal tumor surveillance.