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Not all that is corpus restricted is necessarily autoimmune
  1. Edith Lahner1,
  2. Emanuele Dilaghi2,
  3. Ludovica Dottori1,
  4. Bruno Annibale3
  1. 1Department of Medical-Surgical Sciences and Translational Medicine, University of Rome La Sapienza, Rome, Lazio, Italy
  2. 2Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sant’Andrea Hospital, School of Medicine, University Sapienza, University of Rome La Sapienza, Rome, Italy
  3. 3Clinical Science, University Sapienza Roma, Roma, Italy
  1. Correspondence to Dr Edith Lahner, Department of medical-surgical sciences and translational medicine, University of Rome La Sapienza, Rome, Lazio, Italy; edith.lahner{at}

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We read with interest the paper by Rugge et al on the long-term natural history in Helicobacter pylori (Hp)-negative patients with autoimmune gastritis (AIG)1 whose main findings were that (1) corpus-restricted inflammation, pseudopyloric (PPM) rather than intestinal metaplasia (IM), and enterochromaffin like (ECL)-cell hyperplasia and neoplasia were the main histopathological hallmarks associated with AIG; (2) patients with AIG seem not to have an increased gastric cancer (GC)-risk when previous/current Hp infection is thoroughly excluded, but surveillance for type-1 gastric neuroendocrine tumours (t1-gNETs) risk may be performed.

We fully agree that corpus-restricted inflammation, ECL-cell hyperplasia, t1-gNETs and PPM are findings commonly associated with AIG, although not exclusively present.

ECL-cell hyperplasia is the consequence of increased gastrin and a result of impaired gastric acid secretion due to oxyntic glands atrophy, over time possibly leading to …

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  • Contributors All authors drafted the manuscript whose final version was approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.