High prevalence of autoimmune gastropathy, clinical characteristics and association with hypothyroidism: prospective analisys of 921 patients with gastric biopsies by sydney protocol
Loading...
Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
BACKGROUND: The prevalence of autoimmune gastropathy is increasing, and is considered underdiagnosed. The application of the Sydney protocol for gastric biopsies will probably allow to detect more cases at an early stage. AIM: To determine the prevalence of autoimmune gastropathy in gastric biopsies according to Sydney-OLGA protocol, and define its clinical and laboratory characteristics. Explore the association of autoimmune gastropathy with other autoimmune diseases. METHODS: Single center prospective observational study. Evaluation of gastric biopsies according to Sydney protocol between July 2016 and July 2017 to determine prevalence of autoimmune gastropathy. Autoimmune gastropathy was defined by histologic criteria as gastric corporal exclusive or predominant atrophy. Identification of histologic, clinical and laboratory findings of patients with autoimmune gastropathy. Descriptive statistics and inferential analysis comparing histological findings of autoimmune gastropathy and H. pylori-associated gastropathy. RESULTS: 921 gastric biopsies were evaluated. Mean age was 58 years (range 27-87), 58% female gender. The prevalence of autoimmune gastropathy was 8.8% (81/921). Presence of OLGA stages 3-4 was higher in autoimmune gastropathy than in HP-associated gastropathy (33.3 vs 15.8%, p = 0.004). Age was no different between the two groups (p=0.82). In the characterization of patients with autoimmune gastropathy, the prevalence of gastric polyps in autoimmune gastropathy was 11% (9/81), 4 of then were NETs. In patients with autoimmune gastropathy, only 3.3% had a previous diagnosis of pernicious anemia, and in 11% the reasons for endoscopy was the study of anemia. 18.5% had family history of gastric cancer. The prevalence of hypothyroidism was 30% (24/81). Other autoimmune disease was less frequent (13.5%). CONCLUSION: Our study shows a high prevalence of autoimmune gastropathy detected by gastric biopsies with Sydney protocol. In most cases, clinical characteristics of pernicious anemia was absent and the suspicion for this disease prior to endoscopy was low. Presence of advanced stages of gastric atrophy were frequent. The prevalence of thyrogastric syndrome, autoimmune gastropathy associated to hypothyroidism, was also frequent. The use of Sydney protocol for gastric biopsies allows to detect a higher proportion of patients with autoimmune gastropathy at early stages of the disease.