Abstract
A 7-year-old girl diagnosed with juvenile dermatomyositis during infancy had been receiving immunosuppressive therapy for 5 years and proton pump inhibitors (PPI) for 2 years. She was hospitalized with a 3-week history of vomiting, decreased appetite, and lethargy. Emesis was not bilious or blood-tinged, and she remained afebrile. The physical examination was significant for hirsutism, moon facies, and characteristic skin lesions of dermatomyositis. Although the abdominal examination was unremarkable, the stool was hemoccult-positive. An abdominal radiograph was normal, but an upper gastrointestinal (GI) contrast study revealed several filling defects in the gastric antrum. The patient underwent an upper GI endoscopy that demonstrated 2 nodules and 5 sessile polyps within the antrum (Figure) and duodenal bulb. Polypectomies were performed, and the largest antral polyp was measured at 1.2 cm in diameter. Histology revealed the polyps to be hyperplastic in nature. After removal of the polyps, her symptoms resolved.
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