儿童自身免疫性胃炎

G. Volynets, A. I. Khavkin, A. Potapov, A. Nikitin
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摘要

自身免疫性胃炎,尤其是儿童自身免疫性胃炎的病因尚不清楚。不过,人们正在考虑幽门螺杆菌和 Epstein-Barr 病毒在自身免疫性胃炎发病中的作用。自身免疫性胃炎的形成是基于由 CD4+ T 淋巴细胞介导的自身免疫反应以及胃顶叶细胞抗体的形成,其靶点是胃Н+/К+-АТPase,随后顶叶细胞被破坏,粘膜萎缩。自身免疫性胃炎被认为是一种癌前病变。儿童自身免疫性胃炎的临床表现与消化器官的任何特殊症状无关。腹痛并不常见。消化不良的特殊表现很少见。通常会出现慢性非特异性中毒综合征。大多数患有自身免疫性胃炎的儿童的红细胞计数都在正常年龄范围内。13.8%的患者会出现缺铁性贫血。儿童不会出现维生素B12缺乏性贫血。胃顶叶细胞自身抗体被认为是儿童自身免疫性胃炎的血清标志物和诊断标准。治疗自身免疫性胃炎的目的是预防铁和/或维生素 B12 缺乏症。迄今为止,尚未开发出具体的治疗方法。结论儿童自身免疫性胃炎的发病率被低估了。幽门螺杆菌在自身免疫性胃炎中的作用尚未得到证实。胃顶叶细胞抗体与 Epstein-Barr 病毒 DNA 密切相关。由于存在不良后果和恶性肿瘤的风险,疾病的早期诊断非常重要。萎缩性胃炎和肠化生是癌前病变,虽然在儿童期极为罕见,但不应忽视。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Autoimmune gastritis in children
Etiology of autoimmune gastritis, particularly in children, is still unknown. However, the role of Helicobacter pylori and Epstein–Barr virus in the development of autoimmune gastritis is being considered. The formation of autoimmune gastritis is based on an autoimmune reaction mediated by CD4+ T-lymphocytes and the formation of antibodies to gastric parietal cells, the target of which is gastric Н+/К+-АТPase, with subsequent destruction of parietal cells and the development of mucosal atrophy. Autoimmune gastritis is considered a precancerous condition. The clinical picture of autoimmune gastritis in children is not associated with any specific symptoms of the digestive organs. Abdominal pain is uncommon. Specific manifestations of a dyspeptic nature are rare. Often there is a syndrome of chronic nonspecific intoxication. Red blood counts in most children with autoimmune gastritis are within the age norm. Iron deficiency anemia occurs in 13.8% of patients. Vitamin B12 deficiency anemia does not occur in children. Autoantibodies to the parietal cells of the stomach are considered to be a serum marker and diagnostic criterion for autoimmune gastritis in children. Treatment of autoimmune gastritis is aimed at preventing iron and/or vitamin B12 deficiency. No specific methods of treatment have been developed so far. Conclusion. The incidence of autoimmune gastritis in children is underestimated. The role of Helicobacter pylori in autoimmune gastritis has not been confirmed. There is a close correlation of antibodies to gastric parietal cells with Epstein–Barr viral DNA. Due to adverse outcomes and the risk of malignancy, early diagnosis of the disease is important. Atrophic gastritis and intestinal metaplasia are precancerous conditions, although extremely rare in childhood, they should not be neglected.
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