Issue 4/2026
Topalova-Dimitrova, А.
Gastroenterology Clinic, University Hospital “St. Ivan Rilski” – Sofia
Autoimmune atrophic gastritis is an immune-mediated chronic inflammation of the gastric mucosa that leads to the development of extraintestinal manifestations such as iron-deficiency anemia, pernicious anemia, neuropathy, and funicular myelosis. It is also associated with a high risk of precancerous gastric lesions and gastric neoplasms. The condition is often observed in individuals with other autoimmune diseases. The prevalence of the disease ranges between 0.5% and 2% of the population. It affects females more frequently, particularly between the fifth and sixth decades of life. The inflammatory process in autoimmune atrophic gastritis involves the corpus and fundus of the stomach, leading to atrophy of the parietal cells. As a result, hypo- and achlorhydria develop, along with reduced to absent production of intrinsic factor, which plays a key role in vitamin B12 metabolism. Endoscopic surveillance is necessary in patients with autoimmune atrophic gastritis due to the risk of premalignant lesions and gastric cancer (most commonly type 1 neuroendocrine tumors, i.e., carcinoid tumors).
Adress for correspondence:
Dr. A. Topalova-Dimitrova, MD
Gastroenterology Clinic, University Hospital,
“St. Ivan Rilski” – Sofia
15, „Acad. Ivan Evstratiev Geshov”, Blvd.
1431, Sofia