Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.11.008
Valentina Flagiello , Paolo Gallo , Francesca Terracciani , Andrea Falcomatà , Antonio De Vincentis , Giulia Di Pasquale , Jessica Avagliano , Federica Tavaglione , Silvia Sparapano , Samuel J. Daniels , Jenny E. Blau , Antonio Picardi , Umberto Vespasiani-Gentilucci
There is increasing evidence that visceral adipose tissue (VAT) plays a key role in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD), yet its clinical assessment remains limited by the need for advanced imaging. In this cross-sectional study of 747 patients at metabolic risk, we evaluated whether ultrasound (US)-measured VAT is more strongly associated with hepatic steatosis and metabolic dysfunction than conventional anthropometric indices. Hepatic fat was quantified via ultrasound-derived fat fraction (UDFF), while liver stiffness and FibroScan-AST (FAST) score assessed disease severity. Stratification by VAT tertiles showed a progressive increase in UDFF and the prevalence of diabetes, hypertension, and dyslipidaemia. VAT correlated more strongly than body mass index (BMI) and waist circumference (WC) with triglycerides and UDFF (p < 0.05), and was more strongly associated with HbA1c, ALT and FAST than BMI. In standardized multivariate analysis, VAT remained independently associated with UDFF (beta= 2.49, p < 0.001). Associations of VAT with UDFF and metabolic parameters were stronger in women than in men. These findings support the use of US-derived VAT as a non-invasive and low-cost biomarker to improve risk stratification beyond BMI and WC, serving as a practical tool to monitor response to therapies targeting visceral fat, in MASLD management.
越来越多的证据表明，内脏脂肪组织（VAT）在代谢功能障碍相关脂肪变性肝病（MASLD）的发病机制中起着关键作用，但其临床评估仍然受到先进影像学需求的限制。在这项有代谢风险的747例患者的横断面研究中，我们评估了超声（US）测量的VAT与肝脂肪变性和代谢功能障碍的相关性是否比传统的人体测量指标更强。通过超声衍生脂肪分数（UDFF）量化肝脏脂肪，而肝脏硬度和纤维扫描- ast （FAST）评分评估疾病严重程度。VAT分类显示UDFF和糖尿病、高血压和血脂异常的患病率逐渐增加。VAT与甘油三酯和UDFF的相关性高于体重指数（BMI）和腰围（WC） （p < 0.05），与HbA1c、ALT和FAST的相关性高于BMI。在标准化的多变量分析中，VAT仍然与UDFF独立相关（beta= 2.49, p < 0.001）。VAT与UDFF和代谢参数的相关性在女性中强于男性。这些发现支持使用美国衍生的VAT作为一种非侵入性和低成本的生物标志物来改善BMI和WC之外的风险分层，作为一种实用的工具来监测针对内脏脂肪的治疗在MASLD管理中的反应。
{"title":"Ultrasound-derived visceral adipose tissue as a reliable marker of hepato-metabolic risk in patients with MASLD","authors":"Valentina Flagiello , Paolo Gallo , Francesca Terracciani , Andrea Falcomatà , Antonio De Vincentis , Giulia Di Pasquale , Jessica Avagliano , Federica Tavaglione , Silvia Sparapano , Samuel J. Daniels , Jenny E. Blau , Antonio Picardi , Umberto Vespasiani-Gentilucci","doi":"10.1016/j.dld.2025.11.008","DOIUrl":"10.1016/j.dld.2025.11.008","url":null,"abstract":"<div><div>There is increasing evidence that visceral adipose tissue (VAT) plays a key role in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD), yet its clinical assessment remains limited by the need for advanced imaging. In this cross-sectional study of 747 patients at metabolic risk, we evaluated whether ultrasound (US)-measured VAT is more strongly associated with hepatic steatosis and metabolic dysfunction than conventional anthropometric indices. Hepatic fat was quantified via ultrasound-derived fat fraction (UDFF), while liver stiffness and FibroScan-AST (FAST) score assessed disease severity. Stratification by VAT tertiles showed a progressive increase in UDFF and the prevalence of diabetes, hypertension, and dyslipidaemia. VAT correlated more strongly than body mass index (BMI) and waist circumference (WC) with triglycerides and UDFF (<em>p</em> < 0.05), and was more strongly associated with HbA1c, ALT and FAST than BMI. In standardized multivariate analysis, VAT remained independently associated with UDFF (beta= 2.49, <em>p</em> < 0.001). Associations of VAT with UDFF and metabolic parameters were stronger in women than in men. These findings support the use of US-derived VAT as a non-invasive and low-cost biomarker to improve risk stratification beyond BMI and WC, serving as a practical tool to monitor response to therapies targeting visceral fat, in MASLD management.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 113-118"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145667525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.09.011
Elisabetta Dell'Unto , Dalvinder Mandair , George Riding , Alessandro Rimondi , Maria Rinzivillo , Gianluca Esposito , Tu Vinh Luong , Edith Lahner , Jennifer Watkins , Bruno Annibale , Alberto Murino , Edward John Despott , Martyn Caplin , Marco Marini , Francesco Panzuto , Christos Toumpanakis
Background
Type 1 gastric neuroendocrine tumors (T1-gNETs) are typically indolent. Current guidelines suggest endoscopic surveillance for lesions ≤10 mm, mainly based on expert consensus.
Aim
To evaluate outcomes in patients with T1-gNETs ≤10 mm managed by endoscopic surveillance.
Methods
This dual-center retrospective study (2000–2023) included patients from two Western ENETS Centers of Excellence with T1-gNETs ≤10 mm under surveillance. Primary endpoints were disease progression rate and progression-free survival (PFS); p < 0.05 was considered significant.
Results
A total of 125 patients (66.4 % female; median age 59.5 years) with a median tumor size of 3 mm were analyzed. Most tumors were G1 (92.8 %), and 75.2 % had ≤5 lesions. Over a median follow-up of 72 months, progression occurred in 5 patients (4 %), with no metastases. Low-grade dysplasia was found in 2.4 % and early gastric cancer in 1.6 %. Eleven patients (8.8 %) died, none from tumor-related causes. Restricted mean survival time was 266.5 months. The 5-year PFS rate was 97.8 %. Having ≤5 lesions was significantly associated with lower progression risk (HR = 0.14, 95 % CI: 0.014–0.76, p = 0.022).
Conclusions
T1-gNETs ≤10 mm show low progression risk and can be safely managed with lifelong surveillance. In patients with solitary or few lesions, extended intervals may be appropriate.
{"title":"The indolent nature of type 1 gastric neuroendocrine tumors under 1 cm","authors":"Elisabetta Dell'Unto , Dalvinder Mandair , George Riding , Alessandro Rimondi , Maria Rinzivillo , Gianluca Esposito , Tu Vinh Luong , Edith Lahner , Jennifer Watkins , Bruno Annibale , Alberto Murino , Edward John Despott , Martyn Caplin , Marco Marini , Francesco Panzuto , Christos Toumpanakis","doi":"10.1016/j.dld.2025.09.011","DOIUrl":"10.1016/j.dld.2025.09.011","url":null,"abstract":"<div><h3>Background</h3><div>Type 1 gastric neuroendocrine tumors (T1-gNETs) are typically indolent. Current guidelines suggest endoscopic surveillance for lesions ≤10 mm, mainly based on expert consensus.</div></div><div><h3>Aim</h3><div>To evaluate outcomes in patients with T1-gNETs ≤10 mm managed by endoscopic surveillance.</div></div><div><h3>Methods</h3><div>This dual-center retrospective study (2000–2023) included patients from two Western ENETS Centers of Excellence with T1-gNETs ≤10 mm under surveillance. Primary endpoints were disease progression rate and progression-free survival (PFS); <em>p</em> < 0.05 was considered significant.</div></div><div><h3>Results</h3><div>A total of 125 patients (66.4 % female; median age 59.5 years) with a median tumor size of 3 mm were analyzed. Most tumors were G1 (92.8 %), and 75.2 % had ≤5 lesions. Over a median follow-up of 72 months, progression occurred in 5 patients (4 %), with no metastases. Low-grade dysplasia was found in 2.4 % and early gastric cancer in 1.6 %. Eleven patients (8.8 %) died, none from tumor-related causes. Restricted mean survival time was 266.5 months. The 5-year PFS rate was 97.8 %. Having ≤5 lesions was significantly associated with lower progression risk (HR = 0.14, 95 % CI: 0.014–0.76, <em>p</em> = 0.022).</div></div><div><h3>Conclusions</h3><div>T1-gNETs ≤10 mm show low progression risk and can be safely managed with lifelong surveillance. In patients with solitary or few lesions, extended intervals may be appropriate.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 119-124"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.10.009
Clelia Cavallo, Damiano Martino, Lucia Giuli, Brigida Eleonora Annicchiarico, Antonio Gasbarrini, Francesco Santopaolo
{"title":"Immune dysregulation and porto-sinusoidal vascular disorder: A novel association with BENTA disease","authors":"Clelia Cavallo, Damiano Martino, Lucia Giuli, Brigida Eleonora Annicchiarico, Antonio Gasbarrini, Francesco Santopaolo","doi":"10.1016/j.dld.2025.10.009","DOIUrl":"10.1016/j.dld.2025.10.009","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Page 151"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.10.017
Ana Cisnal , María Lourdes Ruiz Rebollo , César Flórez-Pardo , Jessica Matesanz-Isabel , Javier Pérez Turiel , Juan Carlos Fraile
Background
Acute pancreatitis (AP) progresses to severe forms in about 20 % of cases, leading to high morbidity and mortality. Traditional clinical scoring systems for severity prediction (e.g., Ranson, BISAP), are limited by delayed applicability, and suboptimal diagnostic accuracy.
Aims
To develop and validate machine learning (ML) models for early prediction of moderately severe and severe acute pancreatitis (MSAP-SAP), and to compare them with conventional scores.
Methods
A retrospective cohort of 816 patients (2014–2023) was analyzed. ML models were developed using admission (24-hour) and early (48-hour) data. Models were trained and tested using an 80:20 stratified split and evaluated based on ROC-AUC. F-Anova, Mutual Information and SHapley Additive exPlanations (SHAP) were used for feature selection. SHAP was also used for model interpretability.
Results
The XGBoost model with SHAP-based feature selection (XGBSH) achieved the highest predictive performance with ROC-AUCs of 0.89 (24-hour) and 0.94 (48-hour) on the test cohort. Key predictive features included SIRS, BUN, CRP, creatinine, and pleural effusion. Compared to Ranson and BISAP (both ROC-AUC = 0.72), the XGBSH models demonstrated superior accuracy and allowed flexible, threshold-based classification.
Conclusion
The proposed SHAP-enhanced XGBoost model offers a reliable and interpretable tool for early prediction of AP severity, improving clinical decision-making and patient management.
{"title":"Improved early prediction of acute pancreatitis severity using SHAP-based XGBoost model: Beyond traditional scoring systems","authors":"Ana Cisnal , María Lourdes Ruiz Rebollo , César Flórez-Pardo , Jessica Matesanz-Isabel , Javier Pérez Turiel , Juan Carlos Fraile","doi":"10.1016/j.dld.2025.10.017","DOIUrl":"10.1016/j.dld.2025.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Acute pancreatitis (AP) progresses to severe forms in about 20 % of cases, leading to high morbidity and mortality. Traditional clinical scoring systems for severity prediction (e.g., Ranson, BISAP), are limited by delayed applicability, and suboptimal diagnostic accuracy.</div></div><div><h3>Aims</h3><div>To develop and validate machine learning (ML) models for early prediction of moderately severe and severe acute pancreatitis (MSAP-SAP), and to compare them with conventional scores.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 816 patients (2014–2023) was analyzed. ML models were developed using admission (24-hour) and early (48-hour) data. Models were trained and tested using an 80:20 stratified split and evaluated based on ROC-AUC. F-Anova, Mutual Information and SHapley Additive exPlanations (SHAP) were used for feature selection. SHAP was also used for model interpretability.</div></div><div><h3>Results</h3><div>The XGBoost model with SHAP-based feature selection (XGB<sup>SH</sup>) achieved the highest predictive performance with ROC-AUCs of 0.89 (24-hour) and 0.94 (48-hour) on the test cohort. Key predictive features included SIRS, BUN, CRP, creatinine, and pleural effusion. Compared to Ranson and BISAP (both ROC-AUC = 0.72), the XGB<sup>SH</sup> models demonstrated superior accuracy and allowed flexible, threshold-based classification.</div></div><div><h3>Conclusion</h3><div>The proposed SHAP-enhanced XGBoost model offers a reliable and interpretable tool for early prediction of AP severity, improving clinical decision-making and patient management.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 104-112"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.10.005
S. Dhanya Dedeepya , Vaishali Goel , Nivedita Nikhil Desai
{"title":"Comment on “A prospective study of duodenal laparoscopy-endoscopy cooperative surgery for superficial duodenal tumors, including periampullary lesions”","authors":"S. Dhanya Dedeepya , Vaishali Goel , Nivedita Nikhil Desai","doi":"10.1016/j.dld.2025.10.005","DOIUrl":"10.1016/j.dld.2025.10.005","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 140-141"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.10.010
Luisa Bertin , Andrea Pasta , Matteo Ghisa , Francesco Calabrese , Pierfrancesco Visaggi , Nicola de Bortoli , Vincenzo Savarino , Elisa Marabotto , Edoardo Vincenzo Savarino
Eosinophilic esophagitis (EoE) has emerged as a leading cause of dysphagia worldwide, yet significant knowledge gaps persist across fundamental aspects of disease management. This comprehensive narrative review examines critical research opportunities spanning five interconnected domains that collectively hamper optimal patient care.
Despite advances in understanding type 2 inflammation, EoE pathogenesis remains incompletely characterized, particularly regarding gene-environment interactions, epithelial barrier dysfunction mechanisms, and tissue remodeling pathways. The diagnosis currently relies on endoscopy with biopsies with an arbitrary eosinophil threshold of 15 eosinophils/high-power field, while molecular endotypes and non-invasive biomarkers lack validation. Treatment strategies remain largely empirical without strong evidence-based therapeutic hierarchies, comparative effectiveness data, or reliable response predictors. The lack of head-to-head comparison trials of different interventions limits evidence-based treatment selection, while combination therapy approaches remain mostly underexplored.
Challenges in defining optimal treatment targets persist, as recent eosinophil-depleting biologics achieved histologic responses without symptomatic improvement, highlighting the limitations of eosinophil-centric disease models. Disease trajectory prediction and long-term outcome monitoring lack systematic approaches, while primary prevention strategies remain undefined despite escalating global incidence.
Addressing these research gaps through coordinated multidisciplinary efforts has the potential to transform EoE management from empirical to personalized, evidence-based approaches, ultimately improving patient outcomes and potentially enabling disease prevention.
{"title":"Research gaps in eosinophilic esophagitis: unanswered questions and future directions","authors":"Luisa Bertin , Andrea Pasta , Matteo Ghisa , Francesco Calabrese , Pierfrancesco Visaggi , Nicola de Bortoli , Vincenzo Savarino , Elisa Marabotto , Edoardo Vincenzo Savarino","doi":"10.1016/j.dld.2025.10.010","DOIUrl":"10.1016/j.dld.2025.10.010","url":null,"abstract":"<div><div>Eosinophilic esophagitis (EoE) has emerged as a leading cause of dysphagia worldwide, yet significant knowledge gaps persist across fundamental aspects of disease management. This comprehensive narrative review examines critical research opportunities spanning five interconnected domains that collectively hamper optimal patient care.</div><div>Despite advances in understanding type 2 inflammation, EoE pathogenesis remains incompletely characterized, particularly regarding gene-environment interactions, epithelial barrier dysfunction mechanisms, and tissue remodeling pathways. The diagnosis currently relies on endoscopy with biopsies with an arbitrary eosinophil threshold of 15 eosinophils/high-power field, while molecular endotypes and non-invasive biomarkers lack validation. Treatment strategies remain largely empirical without strong evidence-based therapeutic hierarchies, comparative effectiveness data, or reliable response predictors. The lack of head-to-head comparison trials of different interventions limits evidence-based treatment selection, while combination therapy approaches remain mostly underexplored.</div><div>Challenges in defining optimal treatment targets persist, as recent eosinophil-depleting biologics achieved histologic responses without symptomatic improvement, highlighting the limitations of eosinophil-centric disease models. Disease trajectory prediction and long-term outcome monitoring lack systematic approaches, while primary prevention strategies remain undefined despite escalating global incidence.</div><div>Addressing these research gaps through coordinated multidisciplinary efforts has the potential to transform EoE management from empirical to personalized, evidence-based approaches, ultimately improving patient outcomes and potentially enabling disease prevention.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 23-37"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145344224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.dld.2025.10.015
Edith Lahner , Marco Vincenzo Lenti , Sara Massironi , Fabiana Zingone , Emanuela Miceli , Chiara Della Bella , Federica Facciotti , Filippo Pelizzaro , Bruno Annibale , Mario M D’Elios , Antonio Di Sabatino
Autoimmune atrophic gastritis (AAG) is a non-self-limiting immune-mediated disorder exerting growing interest. The main autoantigen, the beta subunit of the proton pump (H+, K+-ATPase), is localised on the oxyntic mucosa parietal cells, limiting the autoimmune inflammatory damage to this stomach compartment. Clinical manifestations of AAG may occur late, once corpus-fundus atrophy occurs, and are characterised by loss of gastric acidity, impaired iron and/or cobalamin malabsorption, and increased risk of gastric type 1 neuroendocrine neoplasms and possibly gastric adenocarcinoma. Many topics regarding epidemiology, clinical features, pathogenesis, diagnosis, and management remain to be clarified. AAG patients are frequently misdiagnosed or diagnosed with delay.
AAG still represents a clinical challenge and a great opportunity for advancing our knowledge on gastrointestinal autoimmune diseases and gastric precancerous conditions. The timely and correct diagnosis of AAG patients is clinically relevant to avoid potentially harmful consequences due to micronutrient deficiencies and related anaemia and neoplastic complications.
The current position paper addresses AAG in adults and reflects the views of the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO) on its epidemiology, clinical features, pathogenesis, diagnosis, and management.
Improving the understanding of AAG would facilitate timely and accurate diagnosis, enhance clinical management and patients’ quality of life, and reduce the economic and social burden of this underrecognized condition.
{"title":"Autoimmune gastritis: Diagnosis, clinical management and natural history. A position paper by the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO)","authors":"Edith Lahner , Marco Vincenzo Lenti , Sara Massironi , Fabiana Zingone , Emanuela Miceli , Chiara Della Bella , Federica Facciotti , Filippo Pelizzaro , Bruno Annibale , Mario M D’Elios , Antonio Di Sabatino","doi":"10.1016/j.dld.2025.10.015","DOIUrl":"10.1016/j.dld.2025.10.015","url":null,"abstract":"<div><div>Autoimmune atrophic gastritis (AAG) is a non-self-limiting immune-mediated disorder exerting growing interest. The main autoantigen, the beta subunit of the proton pump (<em>H</em>+, <em>K</em>+-ATPase), is localised on the oxyntic mucosa parietal cells, limiting the autoimmune inflammatory damage to this stomach compartment. Clinical manifestations of AAG may occur late, once corpus-fundus atrophy occurs, and are characterised by loss of gastric acidity, impaired iron and/or cobalamin malabsorption, and increased risk of gastric type 1 neuroendocrine neoplasms and possibly gastric adenocarcinoma. Many topics regarding epidemiology, clinical features, pathogenesis, diagnosis, and management remain to be clarified. AAG patients are frequently misdiagnosed or diagnosed with delay.</div><div>AAG still represents a clinical challenge and a great opportunity for advancing our knowledge on gastrointestinal autoimmune diseases and gastric precancerous conditions. The timely and correct diagnosis of AAG patients is clinically relevant to avoid potentially harmful consequences due to micronutrient deficiencies and related anaemia and neoplastic complications.</div><div>The current position paper addresses AAG in adults and reflects the views of the Autoimmune gastRitis Italian netwOrk Study grOup (ARIOSO) on its epidemiology, clinical features, pathogenesis, diagnosis, and management.</div><div>Improving the understanding of AAG would facilitate timely and accurate diagnosis, enhance clinical management and patients’ quality of life, and reduce the economic and social burden of this underrecognized condition.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 1","pages":"Pages 38-50"},"PeriodicalIF":3.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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