Abstract
The aim of the work. To study the effect of concomitant autoimmune thyroiditis (AIT) on the pathomorphological features of lesions of the esophageal mucosa in young patients with gastroesophageal reflux disease (GERD).
 Material and research methods. The study included 165 individuals. The contingent of the surveyed was students of Kharkov higher educational institutions. The main group consisted of 120 patients with a combined course of GERD and AIT, the comparison group included 65 individuals with an isolated GERD. The morphological form of the GERD was revealed during esophagogastroduodenoscopy (“Fuginon” system). A histomorphological study of the obtained biopsy material from the mucous membrane of the esophagus was carried out. Samples were studied on an Olympus BX-41 microscope. Morphometric study of the esophageal mucosa was performed using the Olympus DP-Soft.
 Research results. Histological examination of biopsy specimens revealed that the main pathomorphological signs of GERD in both groups were hyperplasia of the basal zone, lengthening of epithelial papillae, leukocyte infiltration, intercellular edema, expansion of the intercellular space, dystrophic changes, submucous fibrosis, the presence of severe inflammatory infiltration in the submucosal layer. Presence of concomitant AIT was associated with a statistically higher frequency of occurrence of certain signs: hyperplasia of the basal layer of the epithelium, elongation of the papillae, epithelial edema, expansion of the intercellular space, dystrophic changes in the epithelium (p<0.05).
 Conclusions. The presence of concomitant AIT in young patients with GERD does not affect the incidence of erosive GERD, but is associated with a significant increase in the severity of erosive esophagitis. The comorbid course of GERD and AIT in the student population is accompanied by a significant increase in the incidence and statistically significant intensification of the severity of hyperplasia of the basal layer of the epithelium, elongation of connective tissue papillae and leukocyte infiltration compared with isolated GERD
Highlights
Gastroesophageal reflux disease (GERD) takes one the first places among internal diseases which determines the medical problem, and significant socioeconomic implications [1, 2]
Histological examination of biopsy specimens revealed that the main pathomorphological signs of gastroesophageal reflux disease (GERD) in both groups were hyperplasia of the basal zone, lengthening of epithelial papillae, leukocyte infiltration, intercellular edema, expansion of the intercellular space, dystrophic changes, submucous fibrosis, the presence of severe inflammatory rice infiltration in the submucosa (Fig. 2, 3)
Most researchers consider the expansion of the intercellular space, hyperplasia of the basal layer, lengthening of the connective tissue papillae and leukocyte infiltration as the classic histological characteristics of GERD [13, 15]
Summary
Gastroesophageal reflux disease (GERD) takes one the first places among internal diseases which determines the medical problem, and significant socioeconomic implications [1, 2]. To study the effect of concomitant AIT on the pathomorphological features of lesions of the esophageal mucosa in young patients with GERD. Analysis of the incidence of erosive esophagitis various degrees according to the Los Angeles classification in patients with comorbid pathology revealed grade A – 6 (17.7 %), grade B – 18 (52.9 %), grade C – 8 (23.5 %), grade D – 2 (5.9 %) patients; in the comparison group, these indicators were 7 (63.6 %), 3 (27.3 %), 1 (9.1 %) and 0 (0 %), respectively. An integral analysis of the frequency of occurrence of GERD various degrees by groups showed statistically significant reallocation towards strengthening esophagitis in patients with comorbid disorders (df=3, 2=8.772, p=0.033) (Fig. 1)
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