Scandinavian Journal of Gastroenterology. 2014; 49: 1394–1396
LETTER TO THE EDITOR
Noninvasive prediction of chronic atrophic gastritis in autoimmune thyroid disease in primary care
ANTONIO TURSI1, IGNAZIO GRATTAGLIANO1, MANUELA DE POLO1, ENZO PIRROTTA1, PAOLO BACCHIN1, MARCELLO PICCHIO2 & RUDI DE BASTIANI1 1
GIGA-CP (Italian Group for Primary Care Gastroenterology), Feltre (BL), Italy, and 2Division of Surgery, “P. Colombo” Hospital, Velletri (Rome), Italy
Dear Editor, Autoimmune thyroiditis (AT) is often associated with other autoimmune disorders . Autoimmune atrophic gastritis (AG) occurs in 20–30% of asymptomatic patients suffering from AT and likely affects 2–8% of the general population [2,3]. Serum positivity to parietal cell antibodies (APCAs) is a marker of autoimmune AG, but histology is currently the gold standard method owing to its ability to detect each type of AG . The major problem in primary care is to screen and select patients needing consultation and their follow up, including an appropriate timing for endoscopy. Indeed, for this purpose, the role of pepsinogens (PGs) in screening those patients has been suggested [5,6]. GastroPanel (BIOHIT HealthCare, Milan, Italy), a combination of gastrin-17 (G-17), PG-I, PG-II, and Helicobacter pylori antibodies, has been proposed as a simple noninvasive serological test to select patients with a high risk of harboring AG, who deserve endoscopic examination . Therefore, the aim of this study was to assess the role of PGs in assessing the presence of AG in patients suffering from AT, managed in the primary care setting. A total of 160 patients with AT were extracted from the database of 16 Italian primary care physicians. According to the exclusion criteria, 145 of them (130 females, median age 52 years, range 18–70 years) underwent upper gastrointestinal endoscopy with gastric biopsy samples and APCA and GastroPanel after an overnight fasting. The study was approved by the local Ethical Committee.
Figure 1 summarizes the study. Clinical and biochemical features of the study group are reported in Table I. APCA were present in 22 (15.2%) and PG-I/PG-II