Abstract
To investigate characteristics of atrophic gastritis in patients with autoimmune liver disease (ALD), endoscopic congo red-methylene blue tests combined with histological examination were carried out in 24 patients with ALD (including 16 patients with primary biliary cirrhosis (PBC) and 8 patients with autoimmune hepatitis (AIH)), 28 patients with chronic liver disease (CLD) and 33 healthy controls. Parietal cell antibody (PCA) was detected by indirect immunof luorescent test. Serum gastrin levels were also measured. The open type of endoscopic atrophic border was found in 75.0% of patients with ALD, 53.8% of CLD and 48.5% of healthy controls. It suggests that severe gastric mucosal' atrophy was frequently seen in ALD (p<0.05) as compared with others. Intestinal metaplasia was also found extensively in patients with ALD. In the study of serum autoantibody, PCA was found in all of 16 PBC patients (100%), 6 of 8 (75%) AIH patients, 8 of 28 (28.6%) CLD patients and 4 of 33 (12.1%) healthy controls. Serum PCA seems to be common in patients with ALD. The titer of PCA in patients with ALD was also significantly (p <0.001) high, as compared with others. Fasting serum gastrin levels were 160.4±163.4 pg/ml (n= 22) in patients with ALD, 77.6±42.9 pg/ml (n=18) CLD and 81.7±38.0 pg/ml (n=25) healthy controls. Serum gastrin level was significantly higher in patients with ALD (p <0 .05). In conclusion, severe and extensive gastric mucosal atrophy is one of characteristics of gastric lesions in ALD. PCA may be associated with the pathogenesis of this gastric mucosal atrophy. It was suggested that hypergastrinemia was induced by hyposecretion of gastric acid which was caused by severe and extensive fundic mucosal atrophy in relation to destruction of parietal cells.
