Year 2025 / Volume 117 / Number 8
Original
Prevalence and evolution of newly diagnosed autoimmune gastritis in a large Spanish retrospective cohort

441-446

DOI: 10.17235/reed.2025.11101/2025

Esteban Fuentes-Valenzuela, Sergio Escribano Cruz, Javier Parra Villanueva, Almudena Calvache Rodríguez, Ariadna Gil Díaz, María del Carmen López-Martín, Itziar Rubio de la Plaza, Santiago Blanco, Irene Chivato Martín-Falquina, Beatriz Rodríguez-Batllori Aran, Raquel Latorre Martinez, Luis Alonso Castillo Herrera, Rafael Olvera, Daniel Alcalde Rodríguez, Karina Guzmán López, Alicia Bejerano Domínguez,

Abstract
Introduction: There is growing interest in autoimmune gastritis (AIG), particularly regarding its prevalence and natural history. Methods. A retrospective observational study was performed, including all patients with positive parietal cell antibodies who underwent gastroscopy between 2013 and 2023. The first subsequent gastroscopy was defined as follow-up endoscopy and considered for histological comparison. Categorization of histological stages was as follows; stage 0 (potential), stage I (non-atrophic gastritis), stage II (atrophic gastritis) and stage III (dysplasia, neuroendocrine tumor or adenocarcinoma). Results: A total of 426 patients were included, 316 were female with a median of 54.4 years (IQR 45.3-63.2). During this period, a total of 26798 patients underwent at least one upper endoscopy, so the prevalence of AIG was 1.6% (95% CI 1.4-1.7%). Histologically, 105 patients were classified as potential AIG (24.7%), 99 patients as stage I (23,2%), 215 patients as stage II (50.5%) and 7 patients as stage III (1.6%). 153 patients had a follow-up endoscopy. A significant increase of advanced stage disease was observed at follow-up (difference 18.7% 95% CI 7.6%-29%; p=0.001) and a decrease of potential GAI (difference 20.2% 95% CI 11.8% -28.7%; p<0.001). At baseline, 39 patients exhibited hyperplastic polyps (9.2%), 8 patients fundic gland polyps (1.9%), 3 adenomas with low-grade dysplasia (0.7%) and 3 patients presented G1 neuroendocrine tumors (0.7%). Only one patient (0.2%) was diagnosed with signet-ring cell gastric carcinoma. Conclusions: AIG has a low prevalence among patients undergoing gastroscopy. Biopsies in patients with positive parietal cell antibodies showed that around half of the population exhibit significant atrophy and a notable progressive disease.
Lay Summary
Autoimmune gastritis is a chronic disorder caused by autoantibodies. Its evolution and prevalence in the Spanish population are not well-documented. Therefore, the aim of this study was to assess the progression observed at follow-up endoscopy and the prevalence of this condition. For this purpose, a retrospective observational study was conducted, including all patients with positive auto-antibodies and gastroscopy between 2013 and 2023. Four histological stages were considered. Four hundred and twenty-six patients were included. The estimated prevalence was 1.6%. 24.7% were classified as potential autoimmune gastritis, 23,2% as stage I, 50.5% as stage II, and 1.6% as stage III. A significant increase in advanced stages was observed at follow-up (difference 18.72%) and a decrease in potential GAI (difference -20.21%). Only one patient was diagnosed with gastric cancer at baseline. Autoimmune gastritis presents with a low prevalence among patients undergoing gastroscopy. Biopsies revealed that around half of the population exhibited significant atrophy and a notable progressive disease.
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Fuentes-Valenzuela E, Escribano Cruz S, Parra Villanueva J, Calvache Rodríguez A, Gil Díaz A, López-Martín M, et all. Prevalence and evolution of newly diagnosed autoimmune gastritis in a large Spanish retrospective cohort. 11101/2025


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Publication history

Received: 24/01/2025

Accepted: 08/04/2025

Online First: 25/04/2025

Published: 24/07/2025

Article revision time: 64 days

Article Online First time: 91 days

Article editing time: 181 days


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