Introduction
Autoimmune chronic gastritis is an underdiagnosed condition associated with vitamin B12 deficiency, anaemia and increased risk of gastric neoplasia. We aimed to describe the clinical presentation, endoscopic findings and serological profile of patients with histologically confirmed autoimmune gastritis in a Colombian population.
Aims & Methods
We performed a multicentre cross-sectional analytical study including patients diagnosed with autoimmune chronic gastritis between 2020 and 2025 in three referral gastroenterology units. Diagnosis was established based on compatible endoscopic findings (corpus-predominant atrophy), positive serology for anti-parietal cell antibodies and/or intrinsic factor antibodies, and histological confirmation. Descriptive and comparative analyses were performed. Continuous variables were expressed as mean ± standard deviation and categorical variables as proportions with 95% confidence intervals (CI).
Results
Ninety-three patients were included (mean age 56.0 ± 15.3 years; 74% female). Vitamin B12 deficiency was observed in 43% (95% CI 33–53), megaloblastic anaemia in 15% (95% CI 9–24) and iron-deficiency anaemia in 14% (95% CI 8–23). Neurological complications related to cobalamin deficiency were documented in 2% (95% CI 0–7).
Endoscopically, corpus-predominant atrophy was identified in 86% of patients (95% CI 77–92), while 30% (95% CI 21–40) had concomitant gastric polyps. Serological positivity for anti-parietal cell and/or intrinsic factor antibodies was present in 84% (95% CI 75–91).
Patients with vitamin B12 deficiency had a significantly higher prevalence of neurological manifestations compared with those without deficiency (7% vs 0%, p=0.04). Previous diagnosis of chronic gastritis was documented in 86% of cases, suggesting substantial diagnostic delay.
Table. Clinical, endoscopic and serological characteristics of autoimmune chronic gastritis
| Variable | Overall (n=93) | 95% CI | p value |
|---|
| Age, mean ± SD | 56.0 ± 15.3 | — | — |
| Female sex, % | 74% | 64–82 | — |
| Vitamin B12 deficiency, % | 43% | 33–53 | — |
| Megaloblastic anaemia, % | 15% | 9–24 | — |
| Iron-deficiency anaemia, % | 14% | 8–23 | — |
| Neurological manifestations, % | 2% | 0–7 | 0.04* |
| Corpus-predominant atrophy, % | 86% | 77–92 | — |
| Gastric polyps, % | 30% | 21–40 | — |
| Positive autoimmune serology, % | 84% | 75–91 | — |
Conclusion
Autoimmune chronic gastritis remains underrecognised in Latin America and is frequently diagnosed after the development of haematological or neurological complications. Characteristic endoscopic findings combined with serological testing may facilitate earlier diagnosis and risk stratification for gastric neoplasia.
References
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