title: Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review.
abstract: Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach's secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.
authors.affiliation: Federica Cavalcoli, Alessandra Zilli, Dario Conte, Sara Massironi, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Cavalcoli
authors.affiliation: Federica Cavalcoli, Alessandra Zilli, Dario Conte, Sara Massironi, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Zilli
authors.affiliation: Federica Cavalcoli, Alessandra Zilli, Dario Conte, Sara Massironi, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Conte
authors.affiliation: Federica Cavalcoli, Alessandra Zilli, Dario Conte, Sara Massironi, Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Massironi
mesh_terms: D000749:Anemia, Megaloblastic / Q000150:complications / Q000175:diagnosis; D000752:Anemia, Pernicious / Q000150:complications / Q000175:diagnosis; D001206:Ascorbic Acid Deficiency / Q000150:complications / Q000175:diagnosis; D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis; D002118:Calcium / Q000172:deficiency; D002908:Chronic Disease; D005494:Folic Acid Deficiency / Q000150:complications / Q000175:diagnosis; D005757:Gastritis, Atrophic / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D018977:Micronutrients / Q000172:deficiency*; D010024:Osteoporosis / Q000503:physiopathology; D014806:Vitamin B 12 Deficiency / Q000150:complications / Q000175:diagnosis
chemical_list: D018977:Micronutrients; D002118:Calcium
keywords: Calcium; Chronic atrophic autoimmune gastritis; Iron; Malabsorption; Nutritional deficiency; Vitamin B12; Vitamin C; Vitamin D