Department of Internal Medicine, Kenwakai Hospital, Iida, Japan.
Department of Pathology, Kenwakai Hospital, Iida, Japan.
Helicobacter. 2021 Aug;26(4):e12814. doi: 10.1111/hel.12814. Epub 2021 May 11.
Non-Helicobacter pylori Helicobacter (NHPH) is not widely recognized as a cause of acute gastric mucosal lesions (AGML), as only a few cases of AGML caused by NHPH have been reported. We present here one case and examine the species and eradication of NHPH together with the three previously reported cases.
A 52-year-old woman presented with a two-day history of severe epigastric pain, nausea, and vomiting. An esophagogastroduodenoscopy showed mucosal edema, multiple erosions, and ulcerations in the antrum. Biopsy specimens taken from the antrum revealed long spiral-shaped organisms, suggesting NHPH. As both serum anti-Helicobacter pylori (H. pylori) antibody and H. pylori stool antigen test were negative, this case was diagnosed as AGML caused by NHPH. After the administration of esomeprazole 20 mg for 14 days and the interval of the following 12 days, AGML was deemed to have been cured endoscopically. In addition, microscopic examination and PCR analysis confirmed the success of NHPH eradication.
NHPH should be considered a probable cause of AGML in cases that are not attributed to the other causes already recognized. Taking probability of spontaneous eradication into consideration, it is appropriate to start eradication therapy after confirming the chronicity of NHPH infection.
非幽门螺杆菌 Helicobacter(NHPH)并不被广泛认为是急性胃黏膜病变(AGML)的病因,因为仅有少数由 NHPH 引起的 AGML 病例被报道。我们在此报告 1 例,并结合之前报道的 3 例病例,对 NHPH 的种属和根除进行了检查。
一名 52 岁女性因剧烈上腹痛、恶心和呕吐就诊,病史为 2 天。食管胃十二指肠镜检查显示胃窦黏膜水肿,有多处糜烂和溃疡。胃窦活检标本显示长螺旋形生物体,提示为 NHPH。由于血清抗幽门螺杆菌(H. pylori)抗体和 H. pylori 粪便抗原检测均为阴性,因此该病例被诊断为 NHPH 引起的 AGML。给予埃索美拉唑 20 mg 治疗 14 天,间隔 12 天后,AGML 在内镜下被认为已治愈。此外,显微镜检查和 PCR 分析证实 NHPH 已被根除。
在无法归因于已被认识的其他病因的 AGML 病例中,应考虑 NHPH 为可能的病因。考虑到自发性根除的可能性,在确认 NHPH 感染的慢性特征后,开始根除治疗是合适的。