Autoimmune Pangastritis, Report of a Case: Is this a New Disease ? Toru Fujisawa 1 , Mana Fukushima 2 , Akira Kuraishi 1 , Taimei Kaneko 1 , Hiromitsu Mori 1 1Department of Internal Medicine, Nagano Red Cross Hospital 2Department of Laboratory Medicine, Shinshu University School of Medicine Keyword: 自己免疫性胃炎 , CD4/8 , HLA-DR pp.1734-1740
Published Date 2002/12/25
DOI https://doi.org/10.11477/mf.1403104615
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 We report a very rare case of autoimmune pangastritis with severe atrophy, erosion, and hemorrhage. A 64-year-old woman was referred to Nagano Red Cross Hospital in January, 2001 for further examination and treatment of a gastric abnormality. She was complaining of epigastralgia and body weight loss. Endoscopic examination revealed severe atrophy, erosion, and hemorrhage in the body and the antrum of the stomach. Barium meal examination showed progressive rigidity of the whole stomach. Histological findings of many conventional biopsy specimens and a jumbo biopsy specimen using endoscopic mucosal resection revealed no malignancy such as cancer or lymphoma, and no amyloid deposit, but only non specific inflammation. She was followed up for 6 months by conservative therapy using mucosal protective agents and histamine type 2 receptor antagonists, but her condition became worse. The possibility of diffuse, infiltrating type of gastric cancer could not been denied, so total gastrectomy was performed in September, 2001. Histological findings of the resected specimen showed neither gastric cancer nor gastric lymphoma. Analysis of the lymphocyte subset distribution showed that the lamina propria of the stomach contained more CD8 + than CD4 + lymphocytes, further, focal HLA-DR reactivity was shown in the stomach. Since it is clear that this specfic gastritis has association with autoimmune gastritis, we named this case autoimmune pangastritis. This is the first report in medical literature regarding autoimmune pangastritis.

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