Seronegative autoimmune atrophic gastritis is more common in elderly patients.


Journal

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385

Informations de publication

Date de publication:
11 2020
Historique:
received: 26 01 2020
revised: 10 03 2020
accepted: 16 04 2020
pubmed: 4 6 2020
medline: 3 9 2021
entrez: 4 6 2020
Statut: ppublish

Résumé

Autoimmune atrophic gastritis (AAG) diagnosis is based on specific histological findings and anti-parietal cell antibodies (PCA) considered the serological hallmark of AAG, although a subgroup of AAG patients may be seronegative. To assess the occurrence and clinical features of seronegative compared to seropositive AAG. This is a cross-sectional study including 516 consecutive adult patients (age 59.6 ± 12.8 years, F:M = 2.2:1) with histologically proven AAG diagnosed in two Italian academic referral centers over the last 10 years. PCA were detected at AAG diagnosis. Variables related to the dependent variable of interest (i.e.PCA-negativity) were assessed by univariate/logistic regression analysis. 109/516 AAG patients were seronegative. The mean age of seronegative AAG patients was significantly higher compared to PCA-positive (65.9 ± 14.1vs57.9 ± 15.1 years; p<0.0001). The proportion of patients aged 70-79 and ≥80 years were, respectively, lower for PCA-positivity (5.1vs12.8%;21.3vs38.5%;p<0.005). Seronegativity was associated with age ≥50 years (OR2.4;95%CI 1.1-5.2), while for other variables (gender, comorbidities, anemia, atrophy severity) no association was found. In a sub-cohort of 101 AAG patients, PCA levels detected by ELISA were inversely correlated with age at AAG diagnosis (rho=-0.250;p = 0.0118). Roughly 20% of patients are seronegative at the time of AAG histological diagnosis and this is more common in elderly individuals.

Sections du résumé

BACKGROUND
Autoimmune atrophic gastritis (AAG) diagnosis is based on specific histological findings and anti-parietal cell antibodies (PCA) considered the serological hallmark of AAG, although a subgroup of AAG patients may be seronegative.
OBJECTIVES
To assess the occurrence and clinical features of seronegative compared to seropositive AAG.
METHODS
This is a cross-sectional study including 516 consecutive adult patients (age 59.6 ± 12.8 years, F:M = 2.2:1) with histologically proven AAG diagnosed in two Italian academic referral centers over the last 10 years. PCA were detected at AAG diagnosis. Variables related to the dependent variable of interest (i.e.PCA-negativity) were assessed by univariate/logistic regression analysis.
RESULTS
109/516 AAG patients were seronegative. The mean age of seronegative AAG patients was significantly higher compared to PCA-positive (65.9 ± 14.1vs57.9 ± 15.1 years; p<0.0001). The proportion of patients aged 70-79 and ≥80 years were, respectively, lower for PCA-positivity (5.1vs12.8%;21.3vs38.5%;p<0.005). Seronegativity was associated with age ≥50 years (OR2.4;95%CI 1.1-5.2), while for other variables (gender, comorbidities, anemia, atrophy severity) no association was found. In a sub-cohort of 101 AAG patients, PCA levels detected by ELISA were inversely correlated with age at AAG diagnosis (rho=-0.250;p = 0.0118).
CONCLUSION
Roughly 20% of patients are seronegative at the time of AAG histological diagnosis and this is more common in elderly individuals.

Identifiants

pubmed: 32487505
pii: S1590-8658(20)30171-7
doi: 10.1016/j.dld.2020.04.015
pii:
doi:

Substances chimiques

Autoantibodies 0

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1310-1314

Informations de copyright

Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The Authors declare that there is no conflict of interest.

Auteurs

Laura Conti (L)

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. Electronic address: l.conti@uniroma1.it.

Marco Vincenzo Lenti (MV)

First Department of Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Italy.

Antonio Di Sabatino (A)

First Department of Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Italy.

Emanuela Miceli (E)

First Department of Medicine, IRCCS San Matteo Hospital Foundation, University of Pavia, Italy.

Gloria Galli (G)

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

Maria Cazzato (M)

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

Francesca Falangone (F)

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

Bruno Annibale (B)

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

Edith Lahner (E)

Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.

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