Natural History of Autoimmune Gastritis

Two types of gastric atrophy with inflammation (atrophic gastritis) are chronic infection with Helicobacter pylori and autoimmune gastritis (AIG). Patients with chronic H. pylori infection are at excess risk for gastric adenocarcinoma. In contrast, patients with AIG often have antibodies to parietal cells and can develop vitamin B₁₂ deficiency. AIG is associated with development of neuroendocrine tumors (e.g., carcinoid), but whether AIG predisposes to gastric adenocarcinoma has been controversial.

To examine the natural history of AIG, researchers at an Italian referral center described 498 patients with AIG and median follow-up of 18 years. Other potential causes of gastric atrophy were excluded, and endoscopic biopsies were undertaken eve…