Supplementary Material for: A case of autoimmune gastritis and hepatitis with enlarging gastric polyps after reducing the dose of prednisolone

Autoimmune gastritis is immune-mediated gastritis that destroys the oxyntic mucosa. Autoimmune hepatitis is an inflammatory liver disease caused by an autoimmune reaction. These diseases share the same pathogenesis as organ-specific autoimmune disorders; however, cases with both diseases are quite rare and scarcely reported. Here, we report a patient with concurrent autoimmune gastritis and hepatitis who developed enlargement of hyperplastic polyps and progression of gastric atrophy. A 79-year-old woman was referred to our hospital for the treatment of hyperplastic polyps detected on a follow-up upper gastrointestinal endoscopy. Her previous upper gastrointestinal endoscopy from 3 years before referral revealed small hyperplastic polyps and no mucosal atrophy. The current upper gastrointestinal endoscopy revealed three 10-mm red polyps, severe mucosal atrophy in the corpus, and mild atrophy in the antral area. Biopsy samples from the gastric body revealed decreased parietal cells and diffuse lymphocytic infiltration of the deep mucosa. Further, chromogranin A-positive endocrine cell micronests and enterochromaffin-like cell hyperplasia were detected. After confirming the diagnosis of autoimmune gastritis, endoscopic mucosal resection was performed for all polyps histopathologically diagnosed as hyperplastic polyps without malignancy. Clinicians should consider autoimmune gastritis for enlarged hyperplastic polyps and gastric atrophy progresses.