Atrophic Body Gastritis in Patients With Autoimmune Thyroid Disease

Centanni, Marco; Marignani, Massimo; Gargano, Lucilla; Corleto, Vito D.; Casini, Alessandro; Fave, Gianfranco Delle; Andreoli, M; Annibale, Bruno

doi:10.1001/archinte.159.15.1726

Cited by 154 publications

(87 citation statements)

References 26 publications

(54 reference statements)

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“…In a study a few years ago and recently confirmed by another group, concomitant autoimmune gastritis with TAI was present in 33% of patients (27,28). Furthermore, it was shown in another study of patients with TAI that microcytic anemia was present in almost 20% of them, due to concomitant autoimmune gastritis and low ferritin levels (29). We did not measure other antibodies or included hemoglobin levels in our cohort of patients and can thus not draw conclusions on this issue.…”

Section: Discussionmentioning

confidence: 88%

Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

Veltri¹,

Decaillet²,

Kleynen³

et al. 2016

European Journal of Endocrinology

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Objective: Thyroid disorders and iron deficiency (ID) are associated with obstetrical and fetal complications. Iron is essential for the normal functioning of thyroid peroxidase (TPO-abs) and ID is frequent during pregnancy. The aim of this study was to compare the prevalence of thyroid autoimmunity (TAI) and dysfunction during the first trimester of pregnancy in women with and without ID. Design: Cross-sectional data analysis of 1900 pregnant women nested within an ongoing prospective collection of pregnant women's data. Method: The study was performed in a single, tertiary referral center. During the first antenatal visit, ferritin, TPO-abs, thyroid-stimulating hormone (TSH) and free T 4 (FT 4 ) were measured and age and BMI were recorded. ID was defined as ferritin <15 µg/L, TAI when TPO-abs was >60 kIU/L, and subclinical hypothyroidism (SCH) when TSH was >2.5 mIU/L. Results: ID was present in 35% of women. Age and BMI were comparable between both groups. In the ID group, the prevalence of TAI and SCH was significantly higher, compared with that in the non-ID group (10% vs 6% and 20% vs 16%; P = 0.011 and 0.049 respectively). Ferritin was inversely correlated with serum TSH (ρ = −0.076; P = 0.001) and positive with FT 4 levels (ρ = 0.112; P < 0.001). In the logistic regression model, ID remained associated with TAI after correction for confounding factors (P = 0.017). The association with SCH was absent after correction for the confounders in the logistic regression model (P = 0.082), but remained present in the linear regression model (P = 0.035). Conclusions: ID was frequent during the first trimester of pregnancy and was associated with a higher prevalence of TAI, higher serum TSH, and lower FT 4 levels.

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Section: Discussionmentioning

confidence: 88%

Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

Veltri¹,

Decaillet²,

Kleynen³

et al. 2016

European Journal of Endocrinology

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“…AG in the murine model has also been linked to deficiencies in thyroid hormone (19). In humans, AG has been associated clinically with other autoimmune conditions including Type I diabetes mellitus (20), autoimmune thyroid disease (21), and primary biliary cirrhosis (22).…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Gastritis: Distinct Histological and Immunohistochemical Findings Before Complete Loss of Oxyntic Glands

et al. 2002

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Autoimmune gastritis (AG) can be easily recognized when the histological features are fully developed, but recognizing AG before the complete loss of the oxyntic mucosa is more challenging. One feature of fully developed AG is enterochromaffin cell-like (ECL) hyperplasia, but its presence or absence in earlier stages of AG has not been fully evaluated. A retrospective study of biopsy specimens from 40 patients was performed; all of the patients were originally diagnosed with possible AG based on the presence of lymphocytic infiltration and damage to oxyntic glands and/or the presence of metaplastic epithelium that disproportionately involved the body mucosa. Nineteen cases had follow-up serological studies for anti-parietal cells and/or antiintrinsic factor antibodies: 13 were positive and 6 negative. The remaining 21 cases were indeterminate because of incomplete testing. The histological findings were similar in the patients who were serologically positive and those who were indeterminate for AG. In all of these cases, the oxyntic mucosa showed lymphoplasmacytic infiltrates within the lamina propria with focal gland infiltration and damage. Sixty-five percent (22/34) of the cases showed intestinal and/or pyloric metaplasia, and 85% (29/34) showed parietal cell pseudohypertrophy. Chromogranin stains were performed in 11 of 13 cases with positive serological markers for AG, and all showed at least linear ECL cell hyperplasia. In contrast, none of the six cases with negative serological studies had linear ECL cell hyperplasia, P < .001. In conclusion, the following constellation of findings supports a diagnosis of AG before the complete loss of oxyntic mucosa: deep or diffuse lymphoplasmacytic infiltrates within the lamina propria with foci of gland infiltration and damage, epithelial metaplasia, parietal cell pseudohypertrophy, and ECL cell hyperplasia at the linear or greater level.

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“…Previous studies found an important association up to 30% between pernicious anaemia and TD on the basis of gastric and/or thyroid autoantibodies [30,31] and a more recent report assessed the coexistence of ABG and TD on more updated diagnostic criteria [27] . Undiagnosed TD may lead to complications related to subclinical hypo-or hyperthyroidism, which may be prevented by an early diagnosis of TD [13] .…”

Section: Discussionmentioning

confidence: 99%

“…Thyroid hormones and thyroid autoantibodies in serum were determined by commercial kits: free triiodothyronine and free thyroxin levels were assayed by radioimmunoassay (Ares-Serono, Milan, Italy); basal thyrotropin levels were assayed by immunoradiometric assay (Radim Techland, Liege, Belgium); antiperoxidase antibodies were measured by a radioligand assay (Radim Techland, Liege, Belgium) [27] . Thyroid gland size, echogenicity of the parenchyma, and nodular lesions were evaluated by ultrasonographic examination.…”

Section: Patientsmentioning

confidence: 99%

Artificial neural networks in the recognition of the presence of thyroid disease in patients with atrophic body gastritis

Lahner¹,

Intraligi²,

Buscema³

et al. 2008

WJG

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AIM:To investigate the role of artificial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS:A dataset of 29 input variables of 253 atrophic body gastritis patients was applied to artificial neural networks (ANNs) using a data optimisation procedure (standard ANNs, T&T-IS protocol, TWIST protocol). The target variable was the presence of thyroid disease. RESULTS:Standard ANNs obtained a mean accuracy of 64.4% with a sensitivity of 69% and a specificity of 59.8% in recognizing atrophic body gastritis patients with thyroid disease. The optimization procedures (T&T-IS and TWIST protocol) improved the performance of the recognition task yielding a mean accuracy, sensitivity and specificity of 74.7% and 75.8%, 78.8% and 81.8%, and 70.5% and 69.9%, respectively. The increase of sensitivity of the TWIST protocol was statistically significant compared to T&T-IS. CONCLUSION:This study suggests that artificial neural networks may be taken into consideration as a potential clinical decision-support tool for identifying ABG patients at risk for harbouring an unknown thyroid disease and thus requiring diagnostic work-up of their thyroid status.

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Atrophic Body Gastritis in Patients With Autoimmune Thyroid Disease

Cited by 154 publications

References 26 publications

Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

Prevalence of thyroid autoimmunity and dysfunction in women with iron deficiency during early pregnancy: is it altered?

Autoimmune Gastritis: Distinct Histological and Immunohistochemical Findings Before Complete Loss of Oxyntic Glands

Artificial neural networks in the recognition of the presence of thyroid disease in patients with atrophic body gastritis

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