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肝硬化患者停用质子泵抑制剂后胃增生性息肉消失

Disappearance of Gastric Hyperplastic Polyps after the Discontinuation of Proton Pump Inhibitor in a Patient with Liver Cirrhosis.

作者信息

Yasugi Kengo, Haruma Ken, Kawanaka Miwa, Suehiro Mitsuhiko, Nakamura Jun, Urata Noriyo, Tanikawa Tomohiro, Oka Takahito, Monobe Yasumasa, Fujita Takuya, Kawamoto Hirofumi

机构信息

Department of Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.

Department of Pathology, Kawasaki Medical School General Medical Center, Okayama, Japan.

出版信息

Case Rep Gastroenterol. 2021 Feb 18;15(1):202-209. doi: 10.1159/000511885. eCollection 2021 Jan-Apr.

Abstract

Here, we report on a rare case of gastric hyperplastic polyps which disappeared after the discontinuation of proton pump inhibitor (PPI). The patient was an 83-year-old woman with liver cirrhosis and portal hypertension, along with gastroesophageal reflux disease treated by PPI. An initial upper gastrointestinal endoscopy showed unique polypoid lesions in the greater curvature of the stomach. Biopsy specimens of the lesions were diagnosed as hyperplastic polyps and she was followed. One year later, a second endoscopy showed that the lesions had increased in number and size, and an endoscopic mucosal resection (EMR) was performed for the main polyps. The resected specimens indicated a proliferation of foveolar epithelium cells with an increase of capillary ectasia and parietal cell hyperplasia, which was thought to be induced by hypergastrinemia from the PPI. Three months after the EMR, she was admitted because of bleeding from the remaining polyps along with an increase in new polyps. After conservative treatment, PPI was stopped and rebamipide was used. One year and 6 months later, an endoscopy showed the complete disappearance of all gastric polyps.

摘要

在此,我们报告一例罕见的胃增生性息肉病例,该息肉在停用质子泵抑制剂(PPI)后消失。患者为一名83岁女性,患有肝硬化和门静脉高压,同时患有胃食管反流病,接受PPI治疗。初次上消化道内镜检查显示胃大弯处有独特的息肉样病变。病变的活检标本被诊断为增生性息肉,对其进行随访。一年后,第二次内镜检查显示病变数量和大小均增加,对主要息肉进行了内镜黏膜切除术(EMR)。切除标本显示胃小凹上皮细胞增生,伴有毛细血管扩张增加和壁细胞增生,这被认为是由PPI引起的高胃泌素血症所致。EMR术后三个月,她因残留息肉出血及新息肉增多而入院。经过保守治疗,停用PPI并使用瑞巴派特。一年零六个月后,内镜检查显示所有胃息肉完全消失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c53a/7989726/096671e69cbd/crg-0015-0202-g01.jpg

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