Abstract

VALDES SOCIN, H et al. The Thyrogastric Autoimmune Syndrome: Its Effects on Micronutrients and Gastric Tumorigenesis. Rev. argent. endocrinol. metab. [online]. 2014, vol.51, n.1, pp.37-43. ISSN 1851-3034.

The thyrogastric autoimmune syndrome (TAS) was described in patients in whom the serum cross-reacted both with gastric parietal cells antigens and thyroid antigens. We report two cases illustrating the spectrum of pathological features of TAS. The first one is a case of Hashimoto’s Thyroiditis associated with pernicious anemia, further developing a gastric neuroendocrine tumor during follow up. The second one is a case of Graves’ disease and autoimmune reversible gastritis, While type III autoimmune polyendocrinopathy (which includes TAS) is considered to be rare, this was not the case in our experience. A total of 13 % (32/240) of the patients with thyroiditis that we have prospectively followed have also autoimmune gastritis. Helicobacter pylori is clearly implicated in 16 % of the cases of autoimmune gastritis. Infection, malabsorption and gastritis are potentially reversible after bacterial eradication treatment. In the remaining 84 % of patients with gastritis, no histological or serological evidence of Helicobacter pyloriwas found. Gastric autoimmunity is then irreversible, leading to gastric severe atrophy, hypochlorhydria and hypergastrinemia. Hypergastrinemia stimulates enterochromaffin cell hyperplasia, progressing eventually to neuroendocrine tumors. We propose a diagnostic approach to improve the characterization of TAS, including a literature review and discussing some relevant animal models of infectious gastric autoimmunity. Rev Argent Endocrinol Metab 51:37-43, 2014 No financial conflicts of interest exists.

Keywords : Autoimmunity; Thyroiditis; Gastritis; Neuroendocrine tumors; Helicobacter pylori.

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