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      Marked Hypergastrinemia with G-cell Hyperplasia in Two Autoimmune Gastritis Patients

      case-report

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          Abstract

          Gastrin regulates gastric acid secretion, and gastrin secretion itself is regulated by the negative feedback system of gastric acidity. Autoimmune gastritis (AG) is a disease where parietal cells are destroyed, resulting in decreased acid production and an elevated serum gastrin level. We herein report 2 AG cases with marked hypergastrinemia (>5,000 pg/mL). In both cases, 24-hour gastric pH monitoring showed no time when gastric pH was <2, and immunohistochemistry revealed more than 140 gastrin-positive cells per linear millimeter at the antral mucosa. This is the first report to confirm the relationship between marked hypergastrinemia and G-cell hyperplasia with AG.

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          NANETS treatment guidelines: well-differentiated neuroendocrine tumors of the stomach and pancreas.

          Matthew Kulke, Lowell B Anthony, David Bushnell … (2010)
          Well-differentiated neuroendocrine tumors (NETs) of the stomach and pancreas represent 2 major subtypes of gastrointestinal NETs. Historically, there has been little consensus on the classification and management of patients with these tumor subtypes. We provide an overview of well-differentiated NETs of the stomach and pancreas and describe consensus guidelines for the treatment of patients with these malignancies.
          Article 0 comments Cited 103 times – based on 0 reviews     Review now
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            Control of gastric acid secretion in health and disease.

            D A Peura, Heidi Schubert (2008)
            Recent milestones in the understanding of gastric acid secretion and treatment of acid-peptic disorders include the (1) discovery of histamine H(2)-receptors and development of histamine H(2)-receptor antagonists, (2) identification of H(+)K(+)-ATPase as the parietal cell proton pump and development of proton pump inhibitors, and (3) identification of Helicobacter pylori as the major cause of duodenal ulcer and development of effective eradication regimens. This review emphasizes the importance and relevance of gastric acid secretion and its regulation in health and disease. We review the physiology and pathophysiology of acid secretion as well as evidence regarding its inhibition in the management of acid-related clinical conditions.
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              Update on autoimmune polyendocrine syndromes (APS).

              Corrado Betterle, Jose R. Zanchetta (2003)
              Autoimmune Polyendocrine Syndromes (APS) were initially defined as a multiple endocrine gland insufficiency associated to an autoimmune disease in a patient. Neufeld & Blizzard (1980) suggested a classification of APS, based on clinical criteria only, describing four main types. APS-1 is characterized by presence of chronic candidiasis, chronic hypoparathyroidism, Addison's disease. It is a very rare syndrome interesting young subjects correlating to different mutations of AIRE (AutoImmuneRegulator) gene on chromosome 21. APS-2 is characterized by presence of Addison's disease (always present), autoimmune thyroid diseases and/or type 1 diabetes mellitus. It is a rare syndrome interesting particularly adult females and associated to a genetic pattern of HLA DR3/DR4. Autoimmune thyroid diseases associated to other autoimmune diseases (excluding Addison's disease and/or hypoparathyroidism), are the main characteristics of APS-3. The different clinical combinations of autoimmune diseases not included in the previous groups are characteristics of APS-4. In this paper criteria for defining a disease as autoimmune are presented. Furthermore, the classification, epidemiology, pathogenesis, genetic, animal models, clinical features, laboratory's tests, imaging, therapy, recent progresses in understanding the APS and a detailed analysis of large group of our patients affected by different types of APS are proposed and discussed.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Intern Med
                Journal ID (iso-abbrev): Intern. Med
                Title: Internal Medicine
                Publisher: The Japanese Society of Internal Medicine
                ISSN (Print): 0918-2918
                ISSN (Electronic): 1349-7235
                Publication date (Electronic): 29 November 2019
                Publication date (Print): 15 March 2020
                Volume: 59
                Issue: 6
                Pages: 799-803
                Affiliations
                [1 ]Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Japan
                [2 ]Department of Pathology, Graduate School of Medicine, Osaka University, Japan
                [3 ]Department of Metabolism and Atherosclerosis, Graduate School of Medicine, Osaka University, Japan
                [4 ]Department of Diabetes Care Medicine, Graduate School of Medicine, Osaka University, Japan
                Author notes

                Correspondence to Dr.　Sho Yoneda, yoneda@ 123456endmet.med.osaka-u.ac.jp

                Article
                DOI: 10.2169/internalmedicine.3009-19
                PMC ID: 7118375
                PubMed ID: 31787690
                SO-VID: d43df965-f781-46f1-a625-23af1a4bdb79
                Copyright © Copyright © 2020 by The Japanese Society of Internal Medicine
                License:

                The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit ( https://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 11 March 2019
                Date accepted : 15 October 2019
                Categories
                Subject: Case Report

                Keywords: gastrin,autoimmune gastritis,g-cell hyperplasia,achlorhydria
                Data availability:
                Keywords: gastrin, autoimmune gastritis, g-cell hyperplasia, achlorhydria

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