Kawasaki M, Hizawa K, Aoyagi K, Nakamura S, Fujishima M
Second Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Gastroenterol. 1997 Oct;92(10):1909-12.
We herein report a case of a 46-yr-old female with Ménétrièr's disease associated with Helicobacter pylori (H. pylori) infection, in whom the appearance of enlarged gastric folds and hypoproteinemia were both successfully treated by antibacterial treatment. The patient had been treated with famotidine for 3 yr under a diagnosis of Ménétrièr's disease, which caused an increase in her serum protein concentration to a level at which she suffered no clinical problems; however, the concentration never reached a normal range, and the presence of enlarged gastric folds also remained unchanged. Because H. pylori colonization was detected in the stomach and was also retrospectively recognized in the initial histologic specimens, antibacterial treatment with omeprazole, clarithromycin, and metronidazole was thus attempted. As a result of the successful eradication of H. pylori, the enlarged gastric folds returned to normal and the serum protein concentration thus increased to a normal level after the treatment. The etiology of Ménétrièr's disease remains unknown; however, the above findings suggest that H. pylori infection may in some cases cause Ménétrièr's disease and should therefore be carefully treated in any patient with this condition.
我们在此报告一例46岁女性患胃黏膜巨肥厚症并伴有幽门螺杆菌(H. pylori)感染的病例,该患者胃黏膜皱襞增大及低蛋白血症通过抗菌治疗均得到成功改善。该患者在胃黏膜巨肥厚症诊断下接受法莫替丁治疗3年,血清蛋白浓度有所升高,达到无临床问题的水平;然而,该浓度从未达到正常范围,胃黏膜皱襞增大的情况也未改变。由于在胃中检测到幽门螺杆菌定植,且在初始组织学标本中也追溯到该菌,因此尝试用奥美拉唑、克拉霉素和甲硝唑进行抗菌治疗。成功根除幽门螺杆菌后,胃黏膜皱襞恢复正常,治疗后血清蛋白浓度也升至正常水平。胃黏膜巨肥厚症的病因尚不清楚;然而,上述发现表明,幽门螺杆菌感染在某些情况下可能导致胃黏膜巨肥厚症,因此对此类患者应谨慎治疗。