Department of Internal Medicine, Kenwakai Hospital, Iida, Japan.
Department of Pathology, Kenwakai Hospital, Iida, Japan.
Helicobacter. 2021 Aug;26(4):e12811. doi: 10.1111/hel.12811. Epub 2021 Apr 27.
There are only a few reports of non-Helicobacter pylori Helicobacter (NHPH) gastritis in Japanese patients. We aimed to examine its prevalence, clinical features, and esophagogastroduodenoscopy (EGD) findings based on 50 patients encountered in one facility.
Subjects were all patients who had undergone gastric mucosal biopsy endoscopically at Kenwakai Hospital for approximately 10 years. NHPH infection was diagnosed by microscopic findings of Giemsa staining performed on all specimens. PCR analysis of urease genes was performed to detect and identify NHPH, when informed consent was obtained. Helicobacter pylori-diagnostic tests were also performed. NHPH-infected patients were questioned about symptoms and animal contact.
NHPH gastritis was found in 50 of 3847 patients (1.30%). The percentage increased to 3.35% (30 of 896 patients) in the latter 2 years and 4 months with increasing recognition of its characteristic endoscopic findings by endoscopists. PCR analysis, performed in 30 patients, detected NHPH in 28 patients: 26 as Helicobacter suis and 2 as Helicobacter heilmanii/Helicobacter ailurogastricus. Helicobacter pylori-diagnostic tests were almost negative. However, anti-H. pylori antibody showed high-negative titer (3.0-9.9 U/ml) in 12. Of 50 patients (consisting of 49 men and 1 woman), almost all were asymptomatic, and 25 were keeping pets. Regarding EGD findings, in all 50 patients, "crack-like mucosa" and/or nodular gastritis was noted in gastric antrum, and regular arrangement of collecting venules (RAC) was noted in gastric corpus. None of the patients infected with NHPH were co-infected with H. pylori.
The prevalence was finally estimated to be approximately 3.35%. Helicobacter suis was the most common NHPH species. "Crack-like mucosa" and/or nodular gastritis in gastric antrum, RAC in gastric corpus, and H. pylori-negativity by H. pylori-diagnostic tests especially containing a high-negative titer of anti-H. pylori antibody may indicate NHPH infection.
在日本患者中，仅有少数非幽门螺杆菌 Helicobacter（NHPH）胃炎的报道。我们旨在根据一家医疗机构的 50 例患者，研究其患病率、临床特征和内镜检查（EGD）结果。
所有患者均为在健快医院接受内镜下胃黏膜活检的患者，研究时间约为 10 年。通过对所有标本进行吉姆萨染色的显微镜检查来诊断 NHPH 感染。当获得知情同意时，通过 PCR 分析 urease 基因来检测和鉴定 NHPH。还进行了幽门螺杆菌诊断测试。询问 NHPH 感染患者的症状和动物接触情况。
在 3847 例患者中发现 50 例（1.30%）NHPH 胃炎。在后 2 年零 4 个月中，内镜医生对其特征性内镜表现的认识增加，该比例增加至 3.35%（896 例患者中的 30 例）。在 30 例患者中进行了 PCR 分析，在 28 例患者中检测到 NHPH：26 例为猪霍乱螺杆菌，2 例为希氏弯曲菌/猫胃螺杆菌。幽门螺杆菌诊断测试几乎为阴性。然而，12 例患者的抗幽门螺杆菌抗体呈高阴性滴度（3.0-9.9 U/ml）。在 50 例患者中（由 49 名男性和 1 名女性组成），几乎所有患者均无症状，且 25 例患者饲养宠物。关于 EGD 结果，在所有 50 例患者中，均在胃窦部观察到“裂纹样黏膜”和/或结节性胃炎，且在胃体部观察到规则集合静脉（RAC）。没有感染 NHPH 的患者同时感染幽门螺杆菌。
最终患病率估计约为 3.35%。猪霍乱螺杆菌是最常见的 NHPH 物种。胃窦部的“裂纹样黏膜”和/或结节性胃炎、胃体部的 RAC，以及幽门螺杆菌诊断测试的幽门螺杆菌阴性，特别是抗幽门螺杆菌抗体的高阴性滴度可能提示 NHPH 感染。
