Internal and Emergency Medicine

, Volume 13, Issue 5, pp 815–816 | Cite as

Infertility and recurrent miscarriage in a patient with autoimmune atrophic gastritis

  • Marco Vincenzo Lenti
  • Emanuela Miceli
  • Donatella Padula
  • Rossella Colleoni
  • Fausta Beneventi
  • Gino Roberto Corazza
  • Antonio Di SabatinoEmail author

Autoimmune atrophic gastritis (AAG) is an organ-specific disease characterised by stomach corpus and fundus atrophy with subsequent hypo-achlorhydria, lack of intrinsic factor, and vitamin B12 malabsorption, and may predispose to the development of type I neuroendocrine tumours and gastric adenocarcinoma [1]. Little is known regarding AAG pathogenesis and its natural history, but it is generally considered a slowly progressive condition. Patients suffering from AAG may be asymptomatic or may complain of vague and non-specific gastrointestinal and neurological symptoms, or they may just have a family or personal history of other autoimmune disorders (namely autoimmune thyropathy, Addison’s disease, vitiligo, and type I diabetes mellitus) [2]. Most of AAG manifestations and complications are due to vitamin B12 deficiency that may be clinically silent for many years. Vitamin B12deficiency has been associated with infertility, very early recurrent miscarriage, failure of assisted...



Dr. Marco Vincenzo Lenti is grateful to University of Pavia for supporting his research projects.

Author contributions

All the listed authors gave significant contribution to data interpretation and manuscript writing. In particular, MVL collected and analysed data, wrote the manuscript, and is the guarantor of the article. EM, MVL, DP, FB, and RC followed up the patient and reviewed the manuscript. GRC and ADS were involved in data interpretation and major critical revision.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Statements on human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The patient gave approval for the anonymised publication of the case report.


  1. 1.
    Neumann WL, Coss E, Rugge M, Genta RM (2013) Autoimmune atrophic gastritis—pathogenesis, pathology and management. Nat Rev Gastroenterol Hepatol 10:529–541CrossRefPubMedGoogle Scholar
  2. 2.
    Miceli E, Lenti MV, Padula D et al (2012) Common features of patients with autoimmune atrophic gastritis. Clin Gastroenterol Hepatol 10:812–814CrossRefPubMedGoogle Scholar
  3. 3.
    Bennett M (2001) Vitamin B12 deficiency, infertility and recurrent fetal loss. J Reprod Med 46:209–212PubMedGoogle Scholar
  4. 4.
    Reznikoff-Etiévant MF, Zittoun J, Vaylet C, Pernet P, Milliez J (2002) Low vitamin B(12) level as a risk factor for very early recurrent abortion. Eur J Obstet Gynecol Reprod Biol 104:156–159CrossRefPubMedGoogle Scholar
  5. 5.
    Refsum H (2001) Folate, vitamin B12 and homocysteine in relation to birth defects and pregnancy outcome. Br J Nutr 85:S109–S113CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Gaskins AJ, Chiu YH, Williams PL, EARTH Study Team et al (2015) Association between serum folate and vitamin B-12 and outcomes of assisted reproductive technologies. Am J Clin Nutr 102:943–950CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Miceli E, Padula D, Lenti MV et al (2015) A laboratory score in the diagnosis of autoimmune atrophic gastritis: a prospective study. J Clin Gastroenterol 49:e1–e5CrossRefPubMedGoogle Scholar
  8. 8.
    Di Sabatino A, Biagi F, Lenzi M et al (2017) Clinical usefulness of serum antibodies as biomarkers of gastrointestinal and liver diseases. Dig Liver Dis 49:947–956CrossRefPubMedGoogle Scholar
  9. 9.
    Lenti MV, Miceli E, Padula D, Di Sabatino A, Corazza GR (2017) The challenging diagnosis of autoimmune atrophic gastritis. Scand J Gastroenterol 52:471–472CrossRefPubMedGoogle Scholar

Copyright information

© SIMI 2018

Authors and Affiliations

  • Marco Vincenzo Lenti
    • 1
  • Emanuela Miceli
    • 1
  • Donatella Padula
    • 1
  • Rossella Colleoni
    • 2
  • Fausta Beneventi
    • 2
  • Gino Roberto Corazza
    • 1
  • Antonio Di Sabatino
    • 1
    • 3
    Email author
  1. 1.First Department of Internal MedicineSan Matteo Hospital Foundation, University of PaviaPaviaItaly
  2. 2.Departments of Obstetrics and GynecologySan Matteo Hospital Foundation, University of PaviaPaviaItaly
  3. 3.Clinica Medica I, Fondazione IRCCS Policlinico San MatteoUniversità di PaviaPaviaItaly

Personalised recommendations