自己免疫性胃炎初期/早期例の内視鏡像と病理組織像—H. pylori感染合併例を含めた検討

Endoscopic and Histopathological Findings of Early-stage Autoimmune Gastritis

要旨●当院で経験した初期/早期の自己免疫性胃炎症例7例の内視鏡像，病理組織像を遡及的に検討した．男性5例，女性2例で平均年齢は61.3歳であった．6例に偽ポリープの縦走配列，4例に胃小区の発赤腫大を認め，これらは初期/早期の自己免疫性胃炎に特徴的な内視鏡所見である可能性が示唆された．除菌後に胃小区の発赤腫大が出現した症例は，H. pylori感染胃炎に潜在的に合併していた自己免疫性胃炎が除菌後に顕在化したと考えられる．自己免疫性胃炎初期/早期症例の報告はいまだ少なく，今後の症例の蓄積が望まれる．

　Until recently, early-stage AIG（autoimmune gastritis）was rarely diagnosed prior to complete gastric atrophy, due to a lack of knowledge about its endoscopic characteristics.

　In this study, we retrospectively investigated seven patients, including five men and two women, with a mean age of 61.3 years, who had been diagnosed with early-stage AIG at Uji-Tokushukai Medical Center, Uji, Japan. We identified two endoscopic findings, including longitudinal alignment of pseudopolyps and swelling of gastric area with erythema, which characterized early-stage AIG. We diagnosed a patient with early-stage AIG, concealed by active Helicobacter pylori gastritis.