autoimmune gastritis


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  • Names

    • autoimmune gastritis
    • atrophic gastritis
    • type A gastritis

  • Clinical

    • age 50+
    • associated with other autoimmune diseases
    • etiology: antibodies against parietal cells and intrinsic factor -> low acid, B12 deficiency, pernicious anemia
    • feedback: low acid -> increased gastrin

  • Gross

    • site: affects body and fundus, spares antrum
    • loss of rugal folds

  • Histology

    • chronic gastritis (lymphoplasmacytic) in oxyntic gland lamina propria
    • loss of oxyntic glands
    • metaplasia: pseudopyloric metaplasia (mucous cells replacing oxyntic glands), intestinal metaplasia, pancreatic metaplasia

  • Stains

    • gastrin stains antral G cells, but absent elsewhere in stomach, helps establish location
    • chromogranin A stains ECL cell hyperplasia in stomach body
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