Classification — Sakitamiwa

Provide a universal language for endoscopists to describe ulcer activity.

This is for informational purposes only. For medical advice or diagnosis, consult a professional. AI responses may include mistakes. Learn more A preclinical study in a heparinized pig model | PLOS One sakitamiwa classification

Sakita–Miwa classification is a standard endoscopic tool used to stage the life cycle and healing progress of gastric ulcers. It categorizes ulcers into three main stages—Active, Healing, and Scarring—each subdivided into two substages. PubMed Central (PMC) (.gov) The 6 Stages of Sakita–Miwa Provide a universal language for endoscopists to describe

Patients staged within 48 hours of fever onset who receive stage-appropriate therapy (e.g., early ribavirin for Stage I; plasma exchange for Stage III) have a 54% relative risk reduction in progression to Stage IV (NNT = 6). Importantly, the Classification also identifies a subset of (> 5,000 ng/mL) – termed "Sakitamiwa Macrophage Activation Syndrome" – which responds to anakinra (IL-1 blockade) but not corticosteroids. AI responses may include mistakes

The next iteration—Sakitamiwa 4.0 (expected 2026)—aims to incorporate liquid biopsy biomarkers (circulating tumor DNA, exosomal microRNAs) and artificial intelligence-driven whole-slide image analysis. Preliminary data suggest that AI-enhanced Sakitamiwa grading achieves 94% concordance with expert consensus, compared to 78% for human-only grading.

Scoring and stage classification of gastric ulcer according to Sakita-Miwa classification.

The ulcer is deep, covered with a thick white or yellow coating (slough), and the surrounding tissue (gastric wall) is significantly swollen and reddened. A2 (Active 2):