CHRONIC ATROPHIC GASTRITIS AND HELICOBACTER-PYLORI INFECTION IN PRIMARY BILIARY-CIRRHOSIS - A CROSS-SECTIONAL STUDY WITH MATCHING

Background/Aims. Primary, biliary cirrhosis (PBC) is a chronic liver d isease characterized by exocrine gland impairment. Up to now there hav e been no reports dealing with gastric mucosa involvement in this auto immune condition, which is frequently associated with Sjogren's syndro me. The aim of this study was to investigate the morphologic, biochemi cal and immunological features of the gastric mucosa in PBC. Methods. A cross-sectional study with matching was performed. Thirty-three PBC patients (30 F, 3 M, mean age 58 years; 17 with stage II-III, and 16 w ith stage IV disease) and 33 sex- and age-matched dyspeptic controls w ere included. Six biopsy specimens from the fundus (2), body (2) and a ntrum, (2) were taker from all patients and controls. A serological as sessment was performed for each subject, i. e. pepsinogen A (PGA), pep sinogen C (PGC), gastrin (G), and antibodies against Helicobacter pylo ri (anti-Hp IgG). Results. Endoscopic gastritis was found in 22 PBC pa tients (66.6%). There was no difference between PBC patients and contr ols regarding the percentage of subjects with mild, moderate, severe o r atrophic gastritis (AG). There was no difference in gastric mucosal involvement between PBC subjects with or without secondary Sjogren's s yndrome. A discrepancy was observed in the data obtained with respect to Helicobacter pylori (H. pylori) infection. H. pylori colonization w as significantly more frequent in controls than in PBC patients (79% v s 49%, p < 0.002), but anti-Hp Ige were detected in the same percentag e in the two groups (90% vs 83% respectively). There was no difference between the two groups in the PGA, PGC, PGA/PGC ratio, ol gastrin. Ei ght PBC patients had esophageal varices. Conclusions. PBC patients are not characterized by chronic atrophic gastritis, Even though they pre sent chronic gastritis with the same prevalence as dyspeptic controls, and show signs of previous H. pylori infection as frequently as dyspe ptic patients, they are actually much less frequently infected. The re asons for this observation are unclear.