Autoimmune and Chronic Gastritis

by Carlo Raj, MD

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    Let’s move on to Gastritis. With gastritis, we first begin by looking at Type A gastritis. And the reason that I’d specifically did not mention autoimmune right now is because gastritis in a chronic nature there are two types: Type A and Type B. Once again, when you do gastritis, you’ll divide it into acute and chronic. The acute is easy. With acute, we’re dealing with the long-term NSAID use; maybe the patient was drinking alcohol for a long period of time. Acute gastritis. But what I’m saying is, those offending agents were taken for a long period of time resulting in acute gastritis. Now we move into Chronic Gastritis. With chronic gastritis, there’s Type A and Type B. You take the “A” in Type A and use it to your advantage to then call it Autoimmune Gastritis, autoantibodies attacking your parietal cell. Welcome to Pernicious anemia causing Chronic Type A Gastritis. Pernicious anemia. Knocking out the parietal cell absolutely knocks out the acid, we call this Achlorhydia. Achlorhydria, couple of differentials you want to keep in mind: VIPoma, Plummer−Vinson’s Syndrome and obviously, pernicious. Along with no acid, there is no intrinsic factor. Your patient is now rendered B12 deficient. Keep this B12 deficiency caused by pernicious anemia separate from all other B12 deficiencies. By all others I mean maybe your patient: elderly, nursing home, vegan for years; maybe out in the lakes in the Great Lakes, there was a fish tapeworm called <i>Diphyllobothrium latum</i>; maybe there was Crohn’s Disease with damage to the terminal Ileum; you get my point. Keep this separate from all of those. Achlorhydria and B12 deficiency, oh no doubt, this is pernicious anemia. Anti−parietal Cell Antibodies Now not only is an anti−parietal cell antibody, also keep in mind, remember this is autoantibodies, right? These autoantibodies...

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    The lecture Autoimmune and Chronic Gastritis by Carlo Raj, MD is from the course Stomach and Duodenum Diseases.

    Author of lecture Autoimmune and Chronic Gastritis

     Carlo Raj, MD

    Carlo Raj, MD

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