Time course and risk factors of evolution from potential to overt autoimmune gastritis

Background: The natural history of patients with potential autoimmune gastritis (AIG), defined by the presence of serum anti-parietal cell antibody (PCA) positivity and no gastric histopathological alterations, is unknown. We therefore aimed to assess the natural history and clinical correlates of potential autoimmune gastritis (AIG). Methods: In 20 0 0-2019, we enrolled potential AIG patients by monitoring once a year (+/- 6 months) histopathological evolution into overt AIG, defined as the occurrence of atrophy in the oxyntic mucosa. Factors affecting disease progression were assessed. Results: Fifty-one potential AIG patients (median age 57 years, IQR 43-73, F:M ratio 1.7:1) were monitored for up to 15 years (median 6 years, IQR 3-8). Of them, 24 (47.1%) evolved into overt AIG in a median time of 2 years (IQR 2-4.5). Having a concomitant autoimmune disorder (HR 4.09, 95% CI 1.52- 11.00; p = 0.005), but not older age (HR 1.00, 95% CI 0.45-2.22; p = 0.992) and female sex (HR 1.19, 95% CI 0.51-2.78; p = 0.395), was associated with evolution into overt AIG. Conclusions: Roughly one in two potential AIG patients will evolve into overt AIG over a median time of two years, especially those with a concurrent autoimmune disorder. (c) 2021 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Automated summary

Approximately half of potential autoimmune gastritis patients will progress to overt autoimmune gastritis within two years, especially those with concurrent autoimmune disorders.