P4098 - Prevalence of Autoimmune Gastritis Among Dyspepsia Patients in a Country With a Low Prevalence of Helicobacter pylori Infection

Rizki Amalia, MSc¹, Muhammad Miftahussurur, MD, PhD², Ari Fahrial Syam, MD³, Tomohisa Uchida, MD, PhD¹, Ricky Indra Alfaray, MD, PhD¹, Kartika Fauziah, MD, PhD⁴, Dalla Doohan, MD, PhD², Yudith Annisa Ayu Rezkitha, MD², Langgeng Agung Waskito, MD, PhD², Ulfa Kholili, MD², Husin Thamrin, MD², Junko Akada, MD, PhD¹, Takashi Matsumoto, MD, PhD¹, Yoshio Yamaoka, MD, PhD^1
1Oita University, Oita, Oita, Japan; ²Universitas Airlangga, Surabaya, Jawa Timur, Indonesia; ³Universitas Indonesia, Jakarta, Jakarta Raya, Indonesia; ⁴National Research and Innovation Agency, Jakarta, Jakarta Raya, Indonesia

Introduction: Dyspepsia is commonly reported in Indonesia, where the incidence of Helicobacter pylori (H. pylori) infection is considerably lower compared to other Asian countries. Autoimmune Gastritis (AIG) can cause upper gastrointestinal symptoms in the absence of H. pylori infection. AIG, distinct from typical chronic gastritis, may be linked to additional autoimmune conditions and requires specific therapeutic approaches. This study examined the prevalence and the histology alteration character of AIG in Indonesia.

Methods: Sample selection screening was done prior the AIG serology test, with inflammation score in both the antrum and body was considered for sample selection. A total of 89 serum samples were examined for AIG using serology tests. Histopathology was conducted to assess the histological features of biopsy samples, while chemiluminescent enzyme immunoassay (CLEIA) and fluorescent antibody (FA) tests were utilized to accurately evaluate the prevalence of AIG in Indonesia using blood serum.

Results: Of the 89 samples, 79 (89%) were AIG positive based on serology tests. However, seropositivity for Parietal Cell Antibody (PCA) was not significantly associated with H. pylori infection (OR = 2.435; 95% CI = 0.503–11.58; p = 0.18). Histopathology and multivariate logistic regression showed that moderate to high levels of inflammation in the gastric corpus lamina propria are strongly associated with PCA seropositivity (OR = 6.8; 95% CI = 1.56–29.64; p = 0.01), while mucosal atrophy is more associated with H. pylori infection (OR = 5.61; 95% CI = 1.83–17.21; p < 0.01).

Discussion: Understanding the histopathological characteristics of AIG is crucial for facilitating a more comprehensive examination alongside serology tests. Simple histological examination of biopsy samples can offer early insights into the need for further AIG testing and evaluation, particularly in regions like Indonesia where serology tests for AIG remain scarce and costly. The sample with high inflammation in gastric corpus specifically lamina propria, showed high prevalence of AIG based on serology marker. Nonetheless, it's essential to acknowledge the limitations of histological observations from biopsy samples, as the small sample size may not always accurately reflect the true condition of the entire gastric tissue. Nonetheless, serology tests and histopathology can still serve as valuable early screening tools for AIG, particularly in resource-constrained settings.


Disclosures:


Rizki Amalia, MSc¹, Muhammad Miftahussurur, MD, PhD², Ari Fahrial Syam, MD³, Tomohisa Uchida, MD, PhD¹, Ricky Indra Alfaray, MD, PhD¹, Kartika Fauziah, MD, PhD⁴, Dalla Doohan, MD, PhD², Yudith Annisa Ayu Rezkitha, MD², Langgeng Agung Waskito, MD, PhD², Ulfa Kholili, MD², Husin Thamrin, MD², Junko Akada, MD, PhD¹, Takashi Matsumoto, MD, PhD¹, Yoshio Yamaoka, MD, PhD¹. P4098 - Prevalence of Autoimmune Gastritis Among Dyspepsia Patients in a Country With a Low Prevalence of <i>Helicobacter pylori</i> Infection, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.