Chronic atrophic gastritis

Cyano- and hydroxocobalamin - both can be converted to the physiologically relevant coenzymes methyl- and 5 -deoxyadenosylcobalamin in the liver -are used for therapeutical applications. When pernicious anemia caused by chronic atrophic gastritis has been diagnosed, it is treated as follows During the first 7 days of treatment, 1000 pg of hydroxocobalamin/d are administered parenterally, usually intramuscularly. Then, the same dose is given once weekly for 4-6 weeks. The aim is to alleviate the deficiency symptoms and at the same time to replenish the stores. Afterwards, 1000 pg hydroxocobalamin should be given parenterally every 2 months lifelong to avoid relapse [1, 2]. 

Alterations in other gastric secretions, such as pepsinogens and blood group substances also take place in chronic atrophic gastritis. The secretion of pepsinogen I has been used as an indicator of intestinal metaplasia and gastric cancer (21, 22). 

The nitrite results from reduction of nitrate by bacteria abnormally present in the gastric mucosa and the gastric cavity. The bacteria grow situ because the pH is elevated as a result of loss of HCl secretion secondary to the loss of parietal cells and their replacement by intestinal-type epithelium. Parietal cells are lost as a result of chronic atrophic gastritis. What... 

Til et al. (1989) observed adverse gastrointestinal effects at 82 mg/kg/day formaldehyde in male and 109 mg/kg/day formaldehyde in female Wistar rats exposed in drinking water for up to 2 years. Lesions were first seen after 53 weeks. These adverse effects included papillomatous hyperplasia with hyperkeratosis, chronic atrophic gastritis, focal ulceration in the forestomach, and hyperplasia in the glandular stomach. No adverse gastrointestinal effects were noted in the male rats receiving a dose of 15 mg/kg/day. A chronic-duration oral MRL of 0.2 mg/kg/day was derived from the data of Til et al. (1989). The MRL of 0.2 mg/kg/day was based on a NOAEL of 15 mg/kg/day for lack of gastrointestinal effects in male rats and was calculated as described in the footnote to Table 2-4 and in Appendix A of this profile. 

In this context, the consideration of mucosal-associated lymphoid tumors (AAALTs) should not be overlooked. Epidemiologic studies have concluded that H. pylori infection is the major cause of gastric cancer worldwide. The infection increases the risk of gastric adenocarcinoma by three to six times, probably by promoting the development of chronic atrophic gastritis. In addition, H. pylori increases the likelihood of the development of the primary non-Hodgkin s lymphoma AAALT by approximately sixfold. In the majority of circumstances, however, the eradication of H. pylori is associated with complete remission of this disease process. 

The entire spectrum of endocrine cell proliferation, from hyperplasia to dysplasia and neoplasia, has been observed in MEN-1-ZES and diffuse type A chronic atrophic gastritis. Both hyperplastic and pseudohyperplastic changes occur with low frequency in the H. pylori-related chronic gastritis associated with ulcer disease or dyspepsia. 

Three patterns of gastric carcinoid (ECL cell) tumor have been proposed (a) argyrophilic carcinoids arising in type A chronic atrophic gastritis (chronic atrophic gastritis/A), (b) argyrophilic ECL cell carcinoids in MEN-1-ZES, and (c) sporadic argyrophil carcinoids. 

Carcinoids arising in type A chronic atrophic gastritis (type I)... 

Nevertheless, special attention is necessary for the management of patients with large (1.6- to 2.0-cm) and deeply invasive type I well-differentiated ECL tumors that tend to have a low-grade malignant behavior. This clinical profile closely matches that of the 197 chronic atrophic gastritis-associated gastric neuroendocrine tumors previously published and of the 27 similar tumors included in the series of 104 gastric carcinoids recently reported. 

Prevalence of Chronic Atrophic Gastritis (CAG) and Intestinal Metaplasia (IM) in High and Low Risk Groups in Colombia According to Age and Sex... 

AGE NO. OF PATIENTS ABNORMAL (PERCENT) SUPERFICIAL GASTRITIS CHRONIC ATROPHIC GASTRITIS GASTRIC ATROPHY WITH INTESTINAL METAPLASIA NORMAL (PERCENT)... 

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