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Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics)

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Autoimmune gastritis in children

https://doi.org/10.21508/1027-4065-2023-68-6-5-14

Abstract

Etiology of autoimmune gastritis, particularly in children, is still unknown. However, the role of Helicobacter pylori and Epstein–Barr virus in the development of autoimmune gastritis is being considered. The formation of autoimmune gastritis is based on an autoimmune reaction mediated by CD4+ T-lymphocytes and the formation of antibodies to gastric parietal cells, the target of which is gastric Н+/К+-АТPase, with subsequent destruction of parietal cells and the development of mucosal atrophy. Autoimmune gastritis is considered a precancerous condition. The clinical picture of autoimmune gastritis in children is not associated with any specific symptoms of the digestive organs. Abdominal pain is uncommon. Specific manifestations of a dyspeptic nature are rare. Often there is a syndrome of chronic nonspecific intoxication. Red blood counts in most children with autoimmune gastritis are within the age norm. Iron deficiency anemia occurs in 13.8% of patients. Vitamin B12 deficiency anemia does not occur in children. Autoantibodies to the parietal cells of the stomach are considered to be a serum marker and diagnostic criterion for autoimmune gastritis in children. Treatment of autoimmune gastritis is aimed at preventing iron and/or vitamin B12 deficiency. No specific methods of treatment have been developed so far. Conclusion. The incidence of autoimmune gastritis in children is underestimated. The role of Helicobacter pylori in autoimmune gastritis has not been confirmed. There is a close correlation of antibodies to gastric parietal cells with Epstein–Barr viral DNA. Due to adverse outcomes and the risk of malignancy, early diagnosis of the disease is important. Atrophic gastritis and intestinal metaplasia are precancerous conditions, although extremely rare in childhood, they should not be neglected.

About the Authors

G. V. Volynets
Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
Russian Federation

Moscow



A. I. Khavkin
Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
Russian Federation

Moscow



A. S. Potapov
National Medical Research Center for Children’s Health
Russian Federation

Moscow



A. V. Nikitin
Veltischev Research and Clinical Institute for Pediatrics and Pediatric Surgery of the Pirogov Russian National Research Medical University
Russian Federation

Moscow



References

1. Hall S.N., Appelman H.D. Autoimmune Gastritis. Arch Pathol Lab Med. 2019; 143(11): 1327–1331. DOI: 10.5858/arpa.2019–0345-RA

2. Strickland R.G., Mackay I.R. A reappraisal of the nature and significance of chronic atrophic gastritis. Am J Dig Dis. 1973; 18(5): 426–440. DOI: 10.1007/BF01071995

3. Kamada T., Maruyama Y., Monobe Y., Haruma K. Clinical features and endoscopic findings of autoimmune gastritis and resultant gastric tumor. Dig Endosc. 2022; 34(4): 700–713. DOI: 10.1111/den.14175

4. Malik T.H., Sayahan M.Y., Al Ahmed H.A., Hong X. Gastric intestinal metaplasia: an intermediate precancerous lesion in the cascade of gastric carcinogenesis. J Coll Physicians Surg Pak. 2017; 27(3): 166–172

5. Massironi S., Zilli A., Elvevi A., Invernizzi P. The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective. Autoimmun Rev. 2019; 18(3): 215–222. DOI: 10.1016/j.autrev.2018.08.011

6. Song J.H., Kim S.G., Jin E.H., Lim J.H., Yang S.Y. Risk factors for gastric tumorigenesis in underlying gastric mucosal atrophy. Gut Liver. 2017; 11(5): 612–619. DOI: 10.5009/gnl16488

7. Saglietti C., Sciarra A., Abdelrahman K., Schneider V., Karpate A., Nydegger A. et al. Autoimmune gastritis in the pediatric age: an underestimated condition report of two cases and review. Front Pediatr. 2018; 6: 123. DOI: 10.3389/fped.2018.00123

8. Rugge M., Genta R.M., Fassan M., Valentini E., Coati I., Guzzinati S. et al. OLGA gastritis staging for the prediction of gastric cancer risk: a long-term follow-up study of 7436 patients. Am J Gastroenterol. 2018; 113(11): 1621–1628. DOI: 10.1038/s41395–018–0353–8

9. Rugge M., Meggio A., Pravadelli C., Barbareschi M., Fassan M., Gentilini M. et al. Gastritis staging in the endoscopic follow-up for the secondary prevention of gastric cancer: a 5-year prospective study of 1755 patients Gut. 2019; 68(1): 11–17. DOI: 10.1136/gutjnl-2017–314600

10. Ikuse T., Blanchard T.G., Czinn S.J. Inflammation, Immunity, and Vaccine Development for the Gastric Pathogen Helicobacter pylori. Curr Top Microbiol Immunol. 2019; 421: 1–19. DOI: 10.1007/978–3–030–15138–6_1

11. Ding S.Z. Global whole family based- Helicobacter pylori eradication strategy to prevent its related diseases and gastric cancer. World J Gastroenterol. 2020; 26(10): 995–1004. DOI: 10.3748/wjg.v26.i10.995

12. Eusebi L.H., Telese A., Marasco G., Bazzoli F., Zagari R.M. Gastric cancer prevention strategies: a global perspective. J Gastroenterol Hepatol. 2020; 35(9): 1495–1502. DOI: 10.1111/jgh.15037

13. Malfertheiner P., Camargo M.C., El-Omar E., Liou J.M., Peek R., Schulz C. et al. Helicobacter pylori infection. Nat Rev Dis Primers. 2023;9(1):19. DOI: 10.1038/s41572–023–00431–8

14. Ihara T., Ihara N., Kushima R., Haruma K. Rapid Progression of Autoimmune Gastritis after Helicobacter pylori Eradication Therapy: A Case Report. Intern Med. 2023; 62(11): 1603–1609. DOI: 10.2169/internalmedicine.0533–22

15. Kotera T., Nishimi Y., Kushima R., Haruma K. Regression of Autoimmune Gastritis after Eradication of Helicobacter pylori. Case Rep Gastroenterol. 2023; 17(1): 34–40. DOI: 10.1159/000528388

16. Sumi N., Haruma K., Urata N. Autoimmune gastritis with rapid development of corporal atrophy found after H. pylori eradication therapy, report of a case. I to Chou (Stomach and Intestine) 2019; 54: 1053–1057 (in Japanese, Abstract in English). DOI: 10.11477/mf.1403201789

17. Zhang Y., Weck M.N., Schöttker B., Rothenbacher D., Brenner H. Gastric parietal cell antibodies, Helicobacter pylori infection, and chronic atrophic gastritis: evidence from a large population-based study in Germany. Cancer Epidemiol Biomarkers Prev. 2013; 22(5): 821–6. DOI: 10.1158/1055–9965. EPI-12–1343

18. Demir A.M., Berberoğlu Ateş B., Hızal G., Yaman A., Tuna Kırsaçlıoğlu C., Oğuz A.S. et al. Autoimmune atrophic gastritis: The role of Helicobacter pylori infection in children. Helicobacter. 2020; 25(5): e12716. DOI: 10.1111/hel.12716

19. Moreira-Silva H., Silva G., Costa E., Guerra I., Santos-Silva E., Tavares M. et al. Insights Into Pediatric Autoimmune Gastritis: Is There a Role for Helicobacter pylori Infection? J Pediatr Gastroenterol Nutr. 2019; 68(6): e99–e104. DOI: 10.1097/MPG.0000000000002278

20. Volynets G.V. Etiological factors of chronic gastritis in children. Voprosy sovremennoj pediatrii (Moscow). 2006; 5(3): 15–21. (in Russ.)

21. Sarshari B., Mohebbi S.R., Ravanshad M., Shahrokh S., Aghdaei H.A., Zali M.R. Detection and quantification of Epstein– Barr virus, cytomegalovirus, and human herpesvirus-6 in stomach frozen tissue of chronic gastritis and gastric cancer patients. Microbiol Immunol. 2022; 66(8): 379–385. DOI: 10.1111/1348–0421.13013

22. Zhao K., Zhang Y., Xia S., Feng L., Zhou W., Zhang M. et al. Epstein–Barr Virus is Associated with Gastric Cancer Precursor: Atrophic Gastritis. Int J Med Sci. 2022; 19(5): 924–931. DOI: 10.7150/ijms.71820

23. Suzuki Y., Ito S., Nomura K., Matsui A., Kikuchi D., Hoteya S. Multiple Epstein–Barr Virus-associated Gastric Cancers Arising in a Patient with Autoimmune Gastritis. Intern Med. 2023; 62(10): 1459–1466. DOI: 10.2169/internalmedicine.0673–22

24. Yu H., Robertson E.S. Epstein–Barr Virus History and Pathogenesis. Viruses. 2023;15(3):714. DOI: 10.3390/v15030714

25. Rusak E., Chobot A., Krzywicka A., Wenzlau J. Anti-parietal cell antibodies — diagnostic significance. Adv Med Sci. 2016; 61(2): 175–179. DOI: 10.1016/j.advms.2015.12.004

26. Toh B.H. Pathophysiology and laboratory diagnosis of pernicious anemia. Immunol Res. 2017; 65(1): 326–330. DOI: 10.1007/s12026–016–8841–7

27. Volynets G.V. Chronic gastritis in children. LAP LAMBERT, Germany, 2013; 356. (in Russ.) ISBN: 978–3–659–35473–1

28. Shah S.C., Piazuelo M.B., Kuipers E.J., Li D. AGA clinical practice update on the diagnosis and management of atrophic gastritis: expert review. Gastroenterology. 2021; 161(4): 1325–1332.e7. DOI: 10.1053/j.gastro.2021.06.078

29. Kulak O., Gurram B., Montgomery E.A., Park J.Y. Pediatric autoimmune gastritis: clinical correlates and histologic features. Hum Pathol. 2021; 116: 31–38. DOI: 10.1016/j.humpath.2021.07.002

30. Volynets G.V., Khavkin A.I., Nikonov E.L., Murashkin V.Yu., Blat S.F. Endoscopically visualized changes in the mucous membrane of the upper digestive tract in children depending on Helicobacter pylori and Epstein–Barr infections. Dokazatel’naya gastroenterologiya 2018; 7(2): 4–9. (in Russ.) DOI: 10.17116/dokgastro2018724

31. Volynets G.V., Khavkin A.I., Nikonov E.L., Murashkin V.Yu. Features of morphological changes in the gastric mucosa in children depending on Helicobacter pylori infection and Epstein–Barr virus infection. Voprosy detskoi dietologii. 2018; 16(4): 5–12. (in Russ.) DOI: 10.20953/1727–5784–2018–4–5–12

32. Volynets G.V., Belyaev D.L., Vinogradova T.V., Murashkin V.Yu., Babayants A.A., Shapovalova T.G., Semyonov A.V. Approaches to the treatment of autoimmune gastritis in children. Russian Rossiyskiy Vestnik Perinatologii i Pediatrii 2007; 52(6): 33–39. (in Russ.)


Review

For citations:


Volynets G.V., Khavkin A.I., Potapov A.S., Nikitin A.V. Autoimmune gastritis in children. Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics). 2023;68(6):5-14. (In Russ.) https://doi.org/10.21508/1027-4065-2023-68-6-5-14

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ISSN 1027-4065 (Print)
ISSN 2500-2228 (Online)