Journal Article

Chronic Atrophic Gastritis: Early Diagnosis in a Population Where <i>Helicobacter pylori</i> Infection Is Frequent

Sixto Recavarren-Arce, Robert H. Gilman, Raul Leon-Barua, Guillermo Salazar, Jeff McDonald, Roberto Lozano, Fernando Diaz, Alberto Ramirez-Ramos and Robert Berendson

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 5, pages 1006-1012
Published in print November 1997 | ISSN: 1058-4838
Published online November 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516080
Chronic Atrophic Gastritis: Early Diagnosis in a Population Where Helicobacter pylori Infection Is Frequent

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Chronic atrophic gastritis (CAG) is a premalignant condition characterized by loss of gastric antral deep glands. The histologic changes in antral gastric biopsy specimens from 54 Peruvian patients with dyspepsia were studied to detail the development and characteristics of CAG. Ninety-six percent of the biopsies revealed severe superficial mucosal inflammation and 89% showed deep inflammation. Moderate or severe CAG was present in 36 (67%) of the 54 patients. In the early stages of CAG, a glandular lymphoid adherence lesion was noted in 17 (31%) of the 54 biopsy specimens. This lesion consisted of lymphocytes adherent to the antral deep gland cells and was associated with glandular epithelium alterations. The late stage was characterized by small glands, remnants of glands, and gland replacement with a fibrocellular infiltrate or intestinal metaplasia. We propose that the development of CAG probably proceeds via a stereotyped sequence, with an early deep inflammatory component that may trigger local gland destruction and eventual permanent loss.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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