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CASI CLINICI – Case Reports

Volume:

Biochimica Clinica 2015; 39(1) 068-072

Pubblicato on-line:

February 1, 2015

DOI:

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Identificazione casuale di atrofia gastrica severa con macrocitosi complicata da sindrome coronarica acuta
Casual identification of severe gastric atrophy with macrocytosis complicated by acute coronary syndrome

AUTORI

Alberta Caleffi1, Mariella Mercadanti1, Francesco Di Mario2, Giuseppe Lippi1
1U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma
2Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Parma

ABSTRACT

Casual identification of severe gastric atrophy with macrocytosis complicated by acute coronary syndrome

Chronic atrophic gastritis (CAG) and gastric cancer are leading causes of morbidity and mortality worldwide. Serum pepsinogens have been used as biomarkers of gastric mucosa status, including gastric inflammation, so that they might be useful for detection of gastric atrophy or gastric neoplasm at an early stage. Serum pepsinogen 1 and pepsinogen 2 concentrations are known to increase in the presence of Helicobacter pylori-related non-atrophic chronic gastritis, and the eradication of this pathogen is associated with a significant decrease in their values. We describe here the case of an asymptomatic 60 years old man, with a casual serological diagnosis of severe gastric atrophy, macrocytosis and severe complications, culminating in an acute coronary syndrome. This case report raises some important considerations, such as the fact that CAG could not be correctly and early diagnosed and that it may be misleadingly regarded as a rare condition, whereas its prevalence is conversely largely underestimated. This may lead to severe complications that may include gastric malabsorption and vitamin B12 deficiency, along with gastrointestinal, neurologic, psychiatric, cardiovascular, cerebral and peripheral vascular disorders

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