CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2013; 04(04): 119-122
DOI: 10.4103/0976-5042.132420
Case Report
Society of Gastrointestinal Endoscopy of India

Evanescent eosinophilic gastritis in recurrent Helicobacter pylori infection

Mukesh Nasa
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
,
Jignesh Patel
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
,
Ajay Choksey
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
,
Bhumit Patel
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
,
Aniruddha Phadke
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
,
Prabha Sawant
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai, Maharashtra, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

Abstract

Eosinophilic gastroenteritis is characterized histologically by eosinophilic infiltration of the gut wall and clinically manifests by gastrointestinal (GI) symptoms. A high index of suspicion is required for the early diagnosis of this uncommon disease in patients who have concomitant GI symptoms and peripheral eosinophilia. This unusual case who initially had duodenal ulcer with duodenal stenosis, responded to Helicobacter pylori treatment and dilatation. He was symptom free for 2 years. Subsequently, developed evanescent eosinophilic gastritis and recurrent H. pylori infection with refractory prepyloric ulceration, but no duodenal stenosis. Eosinophilic gastritis and H. pylori infection initially responded to treatment, but subsequently the patient developed nonhealing prepyloric ulcer and refractory H. pylori infection and had persistent symptoms; all these necessitated surgical intervention consisting of antrectomy with gastrojejunostomy.

 
  • References

  • 1 Crabtree JE. Role of cytokines in pathogenesis of Helicobacter pylori - induced mucosal damage. Dig Dis Sci 1998;43:46-55S.
  • 2 Bayraktaroglu T, Aras AS, Aydemir S, Davutoğlu C, Ustündağ Y, Atmaca H, et al. Serum levels of tumor necrosis factor-alpha, interleukin-6 and interleukin-8 are not increased in dyspeptic patients with Helicobacter pylori-associated gastritis. Mediators Inflamm 2004;13:25-8.
  • 3 Weller PF. The immunobiology of eosinophils. N Engl J Med 1991;324:1110-8.
  • 4 Saitoh O, Kojima K, Sugi K, Matsuse R, Uchida K, Tabata K, et al. Fecal eosinophil granule-derived proteins reflect disease activity in inflammatory bowel disease. Am J Gastroenterol 1999;94:3513-20.
  • 5 Rothenberg ME. Eosinophilia. N Engl J Med 1998;338:1592-600.
  • 6 Pounder RE, Ng D. The prevalence of Helicobacter pylori infection in different countries. Aliment Pharmacol Ther 1995;9 Suppl 2:33-9.
  • 7 Fiocca R, Luinetti O, Villani L, Chiaravalli AM, Capella C, Solcia E. Epithelial cytotoxicity, immune responses, and inflammatory components of Helicobacter pylori gastritis. Scand J Gastroenterol Suppl 1994;205:11-21.
  • 8 Crabtree JE. Gastric mucosal inflammatory responses to Helicobacter pylori. Aliment Pharmacol Ther 1996;10 (Suppl 1):29-37.
  • 9 Klein NC, Hargrove RL, Sleisenger MH, Jeffries GH. Eosinophilic gastroenteritis. Medicine (Baltimore) 1970;49:299-319.
  • 10 Treiber GG, Weidner S. Eosinophilic Gastroenteritis. Clin Gastroenterol Hepatol 2007;5:e16.
  • 11 Naylor AR. Eosinophilic gastroenteritis. Scott Med J 1990;35:163-5.
  • 12 Jimenez-Saenz M, Villar-Rodriguez JL, Torres Y, Carmona I, Salas-Herrero E, Gonzalez-Vilches J, et al. Biliary tract disease: A rare manifestation of eosinophilic gastroenteritis. Dig Dis Sci 2003;48:624-7.
  • 13 Chen MJ, Chu CH, Lin SC, Shih SC, Wang TE. Eosinophilic gastroenteritis: Clinical experience with 15 patients. World J Gastroenterol 2003;9:2813-6.
  • 14 Papadopoulos AA, Tzathas C, Polymeros D, Ladas SD. Symptomatic eosinophilic gastritis cured with Helicobacter pylori eradication. Gut 2005;54:1818-24.
  • 15 Kawaguchi Y, Mine T, Yasuzaki H, Kusakabe A, Kawana I, Umemura S. Eosinophilic gastroenteritis cured with Helicobacter pylori eradication. J Clin Gastroenterol 2008;42:1063-4.
  • 16 Muller MJ, Sewell GS. Coexistence of eosinophilic gastroenteritis and Helicobacter pylori gastritis: Causality versus coincidence. Dig Dis Sci 2001;46:1784-6.
  • 17 Gisbert JP. The recurrence of Helicobacter pylori infection: Incidence and variables influencing it. A critical review. Am J Gastroenterol 2005;100:2083-99.
  • 18 Xia HX, Talley NJ, Keane CT, O’Morain CA. Recurrence of Helicobacter pylori infection aft er successful eradication: Nature and possible causes. Dig Dis Sci 1997;42:1821-34.
  • 19 Peitz U, Hackelsberger A, Malfertheiner P. A practical approach to patients with refractory Helicobacter pylori infection, or who are re-infected aft er standard therapy. Drugs 1999;57:905-20.
  • 20 Lanas A, Remacha B, Sainz R, Hirschowitz BI. Study of outcome aft er targeted intervention for peptic ulcer resistant to acid suppression therapy. Am J Gastroenterol 2000;95:513-9.
  • 21 Bilardi C, Biagini R, Dulbecco P, Iiritano E, Gambaro C, Mele MR, et al. Stool antigen assay (HpSA) is less reliable than urea breath test for post-treatment diagnosis of Helicobacter pylori infection. Aliment Pharmacol Ther 2002;16:1733-8.
  • 22 Duck WM, Sobel J, Pruckler JM, Song Q, Swerdlow D, Friedman C, et al. Antimicrobial resistance incidence and risk factors among Helicobacter pylori-infected persons, United States. Emerg Infect Dis 2004;10:1088-94.
  • 23 Osato MS, Reddy R, Reddy SG. Pattern of primary resistance of Helicobacter pylori to metronidazole or clarithromycin in the United States. Arch Int Med 2001;161:1217-20.
  • 24 Torres J, Camorlinga-Ponce M, Pérez-Pérez G, Madrazo-De la Garza A, Dehesa M, González-Valencia G, et al. Increasing multidrug resistance in Helicobacter pylori strains isolated from children and adults in Mexico. J Clin Microbiol 2001;39:2677-80.
  • 25 Heep M, Kist M, Strobel S, Beck D, Lehn N. Secondary resistance among 554 isolates of Helicobacter pylori aft er failure of therapy. Eur J Clin Microbiol Infect Dis 2000;19:538-41.
  • 26 McGovern TW, Talley NJ, Kephart GM, Carpenter HA, Gleich GJ. Eosinophil infiltration and degranulation in Helicobacter pylori-associated chronic gastritis. Dig Dis Sci 1991;36:435-40.