我们希望提供更新的综合视角，并确定与慢性自发性荨麻疹 (CSU) 相关的成分，而无自身免疫性萎缩性胃炎 (AAG) 的特定触发因素。 AAG 是一种影响胃底胃粘膜的器官特异性自身免疫性疾病。尽管我们缺乏对潜在途径的统一解释，但考虑到文献中报道的所有儿科患者，改变会导致胃神经内分泌肠嗜铬样（ECL）细胞增殖和组胺的旁分泌释放。对于 CSU 的发病机制，人们提出了多种机制，大量证据表明 AAG 和 ECL 细胞反应，这可能是导致 CSU 的潜在因素。组胺过量产生/释放到血流中可能导致或触发 AAG 中 CSU 的恶化，与幽门螺杆菌无关；因此，ECL 细胞释放的组胺可能是主要调节剂。考虑到对这些相互作用的理解，认识到 AAG 在 CSU 发病机制中各自的作用可能会强烈影响不明原因/难治性 CSU 的诊断检查和管理，并可能为未来提供信息儿科人群的研究和干预。• 自身免疫性萎缩性胃炎是一种慢性免疫介导的炎症性疾病，其特征是胃体和胃底泌酸粘膜破坏、粘膜萎缩和化生改变。 • 儿科患者中的自身免疫性萎缩性胃炎非常重要，因为其预后较差，存在恶性肿瘤风险，并且主要在单例报告中可能低估了实体。 • 独立于幽门螺杆菌的上消化道炎症性疾病已被认为是潜在的诱发因素。慢性自发性荨麻疹的发展。 • 如果儿科患者出现贫血、维生素 B12 水平降低、无其他可检测病因的复发性荨麻疹、抗壁细胞抗体阳性以及胃泌素水平升高等症状，则应将自身免疫性萎缩性胃炎视为慢性荨麻疹的可能原因。 © 2023。作者。

We would like to provide an updated comprehensive perspective and identify the components linked to chronic spontaneous urticaria (CSU) without specific triggers in autoimmune atrophic gastritis (AAG). AAG is an organ-specific autoimmune disease that affects the corpus-fundus gastric mucosa. Although we lack a unified explanation of the underlying pathways, when considering all paediatric patients reported in the literature, alterations result in gastric neuroendocrine enterochromaffin-like (ECL) cell proliferation and paracrine release of histamine. Several mechanisms have been proposed for the pathogenesis of CSU, with much evidence pointing towards AAG and ECL cell responses, which may be implicated as potential factors contributing to CSU. The excessive production/release of histamine into the bloodstream could cause or trigger exacerbations of CSU in AAG, independent of Helicobacter pylori; thus, the release of histamine from ECL cells may be the primary modulator.Considering the understanding of these interactions, recognising the respective roles of AAG in the pathogenesis of CSU may strongly impact the diagnostic workup and management of unexplained/refractory CSU and may inform future research and interventions in the paediatric population.• Autoimmune atrophic gastritis is a chronic immune-mediated inflammatory disease characterised by the destruction of the oxyntic mucosa in the gastric body and fundus, mucosal atrophy, and metaplastic changes. • Autoimmune atrophic gastritis in paediatric patients is important because of the poor outcome and risk of malignancy and possibly underestimated entities primarily reported in single-case reports.• Upper gastrointestinal inflammatory disorders, independent of H. pylori, have been implicated as potential inducing factors in the development of chronic spontaneous urticaria. • If a paediatric patient presents with symptoms such as anaemia, reduced vitamin B12 levels, recurrent urticaria with no other detectable aetiology, positive anti-parietal cell antibodies, and elevated gastrin levels, autoimmune atrophic gastritis should be considered a possible cause of chronic urticaria.© 2023. The Author(s).