Prevalence of Autoimmune Atrophic Gastritis in Vitiligo

Abstract

Gastric biopsies, and measurements of fasting serum gastrin levels and titers of antihuman parietal cell antibodies have been performed in 65 unselected patients with vitiligo. Histologic evidence of autoimmune atrophic gastritis has been obtained in 10 cases (15 %), who were all positive for the antibodies and who had elevated gastrin levels. The study of gastric secretion after pentagastrin stimulation, performed in 7 of these patients, showed a markedly reduced acid output. The present study provides definite evidence of the association of autoimmune atrophic gastritis with a proportion of vitiligo cases and suggests the need for surveillance of these patients in terms of gastric neoplasia.

Circulating Autoantibodies and Autoimmune Comorbidities in Vitiligo Patients: A Multicenter Italian Study

“…APCAs were detected in vitiligo patients in rates ranging from 2.5 to 35.4% (table 4) [7,9,10,11,12,23,24,26,27,28,29,30,31,32,33]. We detected an APCA prevalence of 7.8% in our series consistent with the lower estimates from other studies.…”

“…Nevertheless the analysis of existing data is difficult, owing to the heterogeneity of examined samples of patients and the diversity of searched autoantibodies. From our review of the literature, the prevalence of reported autoimmune diseases, according to history and/or clinical and instrumental findings, ranged from 2.7 to 55% [2,6,7,8,9,10,11,12,13,14,15,16,17,18]. The rates of autoimmune comorbidities in vitiligo patients appear to differ based on the population under study, according to ethnic differences [18].…”

“…Sawicki et al [34] noticed a statistical difference in the prevalence of anemia perniciosa between their vitiligo patients and the general population in Canada. Autoimmune gastritis confirmed by histology was observed in 3.5% [24] and 15% [11] of cases of vitiligo in Italy, but data on the prevalence of this autoimmune disease in the general population are lacking. In the study performed by Betterle et al [7], 94% of vitiligo patients with circulating APCAs were affected by autoimmune gastritis.…”

Autoimmune Melanocyte Destruction in Vitiligo

“…The pattern of relationship between relative risk and degree of kinship indicates that the disease is associated with genetic loci on different chromosomes, which points to a polygenic nature of the disease (Das et al, 1985;Majumder et al, 1993). In relation to this, it is known that vitiligo is frequently associated with several other autoimmune diseases including uveitis (Park et al, 1992), diabetes mellitus (Gould et al, 1985), autoimmune thyroid disease (Hegedus et al, 1994), and atrophic gastritis (Zauli et al, 1986). Further, several positive human leukocyte antigen (HLA)-associations for vitiligo have been reported: HLA-A2, HLA-Dw7 (Buc et al, 1996), HLA-DR4 (Dunston and Halder, 1990;Foley et al, 1983), B13, Bw35 (Metzker et al, 1980), Cw7, and DR6 (Venneker et al, 1993).…”

Staphylococcus aureus and Etretinate

“…In fact, in unselected patients with vitiligo, a good correlation among histopathology, gastrin levels, and high-titer HPCA has been previously found. 8 Similarly, in AA, all the cases with histologically proven AG had elevated gastrin, and all but one were HPCA positive. Moreover, none of the patients with normal gastrinemia were HPCA positive, and only one patient with hypergastrinemia had no evidence of AG.…”