graph LR
Peripheral_Neuropathy["Peripheral Neuropathy"]
Intrinsic_Factor_Deficiency_and_B12_Malabsorption["Intrinsic Factor Deficiency and B12 Malabsorption"]
Atrophic_Gastritis["Atrophic Gastritis"]
Gastric_Neuroendocrine_Tumor["Gastric Neuroendocrine Tumor"]
Glossitis["Glossitis"]
Pernicious_Anemia["Pernicious Anemia"]
Hypergastrinemia["Hypergastrinemia"]
Gastric_Adenocarcinoma["Gastric Adenocarcinoma"]
Parietal_Cell_Destruction_and_Oxyntic_Atrophy["Parietal Cell Destruction and Oxyntic Atrophy"]
Hypergastrinemia_and_ECL_Cell_Hyperplasia["Hypergastrinemia and ECL Cell Hyperplasia"]
Somatostatin_Analog_Therapy["Somatostatin Analog Therapy"]
CD4+_T_Cell_Mediated_Autoimmune_Response_Against_the_Gastric_Proton_Pump["CD4+ T Cell-Mediated Autoimmune Response Against the Gastric Proton Pump"]
Iron_Deficiency_Anemia["Iron Deficiency Anemia"]
Netazepide_Gastrin_CCK2_Receptor_Antagonist["Netazepide (Gastrin/CCK2 Receptor Antagonist)"]
Endoscopic_Resection_of_Gastric_Neuroendocrine_Tumors["Endoscopic Resection of Gastric Neuroendocrine Tumors"]
Achlorhydria["Achlorhydria"]
CD4+_T_Cell_Mediated_Autoimmune_Response_Against_the_Gastric_Proton_Pump --> Parietal_Cell_Destruction_and_Oxyntic_Atrophy
Parietal_Cell_Destruction_and_Oxyntic_Atrophy --> Atrophic_Gastritis
Parietal_Cell_Destruction_and_Oxyntic_Atrophy --> Achlorhydria
Parietal_Cell_Destruction_and_Oxyntic_Atrophy --> Iron_Deficiency_Anemia
Parietal_Cell_Destruction_and_Oxyntic_Atrophy --> Intrinsic_Factor_Deficiency_and_B12_Malabsorption
Parietal_Cell_Destruction_and_Oxyntic_Atrophy --> Hypergastrinemia_and_ECL_Cell_Hyperplasia
Parietal_Cell_Destruction_and_Oxyntic_Atrophy --> Gastric_Adenocarcinoma
Intrinsic_Factor_Deficiency_and_B12_Malabsorption --> Pernicious_Anemia
Intrinsic_Factor_Deficiency_and_B12_Malabsorption --> Peripheral_Neuropathy
Intrinsic_Factor_Deficiency_and_B12_Malabsorption --> Glossitis
Hypergastrinemia_and_ECL_Cell_Hyperplasia --> Hypergastrinemia
Hypergastrinemia_and_ECL_Cell_Hyperplasia --> Gastric_Neuroendocrine_Tumor
Netazepide_Gastrin_CCK2_Receptor_Antagonist --> Gastric_Neuroendocrine_Tumor
Endoscopic_Resection_of_Gastric_Neuroendocrine_Tumors --> Gastric_Neuroendocrine_Tumor
Somatostatin_Analog_Therapy --> Gastric_Neuroendocrine_Tumor
style Peripheral_Neuropathy fill:#fef3c7
style Intrinsic_Factor_Deficiency_and_B12_Malabsorption fill:#dbeafe
style Atrophic_Gastritis fill:#fef3c7
style Gastric_Neuroendocrine_Tumor fill:#fef3c7
style Glossitis fill:#fef3c7
style Pernicious_Anemia fill:#fef3c7
style Hypergastrinemia fill:#fef3c7
style Gastric_Adenocarcinoma fill:#fef3c7
style Parietal_Cell_Destruction_and_Oxyntic_Atrophy fill:#dbeafe
style Hypergastrinemia_and_ECL_Cell_Hyperplasia fill:#dbeafe
style Somatostatin_Analog_Therapy fill:#fce7f3
style CD4+_T_Cell_Mediated_Autoimmune_Response_Against_the_Gastric_Proton_Pump fill:#dbeafe
style Iron_Deficiency_Anemia fill:#fef3c7
style Netazepide_Gastrin_CCK2_Receptor_Antagonist fill:#fce7f3
style Endoscopic_Resection_of_Gastric_Neuroendocrine_Tumors fill:#fce7f3
style Achlorhydria fill:#fef3c7
name: com_Autoimmune_Gastritis__Hashimotos_Thyroiditis
creation_date: '2026-07-01T00:00:00Z'
curation_status: CANDIDATE
notes: >-
Thyrogastric syndrome: the frequent co-occurrence of autoimmune (atrophic)
gastritis and autoimmune thyroid disease (Hashimoto thyroiditis) is the most
characteristic polyautoimmune pairing for autoimmune gastritis, reflecting a
shared organ-specific autoimmune susceptibility. Autoimmune gastritis also
clusters with type 1 diabetes mellitus and vitiligo; those pairings could be
captured as additional comorbidity entries.
disease_a:
slug: Autoimmune_Gastritis
preferred_term: Autoimmune Gastritis
term:
id: MONDO:0031014
label: autoimmune gastritis
disease_b:
slug: Hashimotos_Thyroiditis
preferred_term: Hashimoto thyroiditis
term:
id: MONDO:0007699
label: Hashimoto thyroiditis
directionality: BIDIRECTIONAL
literature_evidence:
- reference: PMID:31864909
reference_title: "Thyro-entero-gastric autoimmunity: Pathophysiology and implications for patient management."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "autoimmune thyroid disorders, in particular Hashimoto's thyroiditis, may be frequently associated with other organ-specific, immune-mediated disorders, such as autoimmune atrophic gastritis or celiac disease."
explanation: Establishes the frequent association of Hashimoto thyroiditis with autoimmune atrophic gastritis - the thyrogastric syndrome.
- reference: PMID:28102858
reference_title: "Luminescent Immunoprecipitation System (LIPS) for Detection of Autoantibodies Against ATP4A and ATP4B Subunits of Gastric Proton Pump H+,K+-ATPase in Atrophic Body Gastritis Patients."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "prevalence of ~2% in the general population and up to 10% in patients with other autoimmune diseases, such as type I diabetes or autoimmune thyroid disease."
explanation: Autoimmune gastritis prevalence rises to ~10% among patients with other autoimmune diseases, including autoimmune thyroid disease.
hypotheses:
- description: >-
Shared organ-specific autoimmune susceptibility - HLA class II haplotypes plus
non-HLA loci such as PTPN22 - predisposes to both autoimmune gastritis and
autoimmune thyroid disease, manifesting as thyrogastric polyautoimmunity rather
than one condition causing the other.
evidence:
- reference: PMID:34145262
reference_title: "Genome-wide association study identifies five risk loci for pernicious anemia."
supports: SUPPORT
evidence_source: HUMAN_CLINICAL
snippet: "We conduct a genome-wide association study meta-analysis in 2166 cases and 659,516 European controls from population-based biobanks and identify genome-wide significant signals in or near the PTPN22"
explanation: The PTPN22/HLA susceptibility architecture of pernicious anemia / autoimmune gastritis is shared with other organ-specific autoimmune diseases including autoimmune thyroid disease.