A0691 - Host-Related Gastritides: Diagnostic Footnotes or Neglected Diseases?

Kevin Turner, DO¹, Massimo Rugge, MD², Robert M. Genta, MD^3
1University of Minnesota Medical School, Minneapolis, MN; ²University of Padua, Baylor College of Medicine, Padua, Veneto, Italy; ³Inform Diagnostics, Baylor College of Medicine, Dallas, TX

Introduction: While the Kyoto Global Consensus Report on Gastritis focused on H. pylori, it also discussed those gastritides that, for lack of a better understanding of their etiology, appear to stem from immune mediated imbalances within the host. These include autoimmune atrophic gastritis (AIG), lymphocytic (LyG), eosinophilic (EoG), collagenous (CG), idiopathic granulomatous (GrG), and Hp-negative chronic active gastritis (Hp-neg CAG). The purpose of this study was to determine how frequently these conditions were diagnosed in a large US database of patients who had gastric biopsies over a period of 12 years.

Methods: We extracted all patients with a gastric biopsy between 2008-2020 from Inform Diagnostic’s IDEA database, a large database of codified pathology reports. We then calculated the frequency of AIG, LyG, EoG, CG, GrG, and Hp-neg-CAG and their corresponding age and gender statistics.

Results: The frequency of the diagnoses of the host-related gastritides is depicted in Table 1. Of 1,510,775 unique patients who had gastric biopsies, these gastritides accounted for < 2% of all diagnoses, in contrast, for example to 9.5% for H. pylori gastritis.

Discussion: The reported frequencies are based exclusively on the diagnoses generated by gastrointestinal pathologists using predetermined diagnostic keys in one large, specialized laboratory. A very small number of diagnoses may have been missed because some pathologists may occasionally use an uncoded phrase of a descriptive diagnosis. This may be particularly true in the case of AIG, which some pathologists prefer to diagnose descriptively, and EoG, which has no accepted diagnostic guidelines. In spite of their low prevalence, these forms of gastritis need to be recognized, followed up, and in some cases treated. Thus, their rarity should not make them any less relevant to the clinical community.



Disclosures:


Kevin Turner, DO¹, Massimo Rugge, MD², Robert M. Genta, MD³. A0691 - Host-Related Gastritides: Diagnostic Footnotes or Neglected Diseases?, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.