Données nouvelles relatives aux fondements dynamiques et étiopathogéniques de la gastrite et de l'anémie de Biermer

Abstract

Chronic gastritis is classified in three groups, which have separate dynamical and biological behaviour. of these, type A gastritis affects mainly the gastric body mucosa, and type B gastritis mainly the antral mucosa whereas type AB gastritis («pangastritis») affects simultaneously both areas. Type A gastritis appears to be identical with the gastric lesion of overt pernicious anemia, and is significantly more often found in first-degree relatives of pernicious anemia patients than in matched controls from the general population. Dynamic and pedigree analyses of pernicious anemia families suggest that the rapid atrophy of normal fundal glands in type A gastritis is mainly caused by a single major factor («Factor A»), which is inherited by an autosomal dominant way. Severe atrophy of normal fundal glands leads to typical alterations of the gastric secretion, and is often associated with immunological phenomena. Type B gastritis shares the main characteristics of gastritis that starts in antrum and extends upwards along the lesser curvature. This type of gastritis is associated with normal or high secretion of hydrochloric acid and with normal or elevated level of serum pepsinogen group I. Type B gastritis is more common in duodenal ulcer families than in age- and sex-matched controls of a population sample. Dynamically this type of gastritis differs from the main behaviour of population samples in that in the body mucosa outside the lesser curvature the process is slowed up at the stage of superficial gastritis and virtually no atrophic changes appear with age. Type AB gastritis affects simultaneously both gastric body and antrum mucosa, but is in general more severe in antrum. Some dynamic data of our team suggest that this type of gastritis represents the main behaviour of the population at large. Also this type of gastritis aggregates in families, but nothing is known of its etiopathogenetic background.