Abstract
Helicobacter pylori (H. pylori) has been found to be the major cause for gastroduodenal pathology, both in adults and children, a finding which resulted in a new understanding and approach of chronic active gastritis, duodenal ulcers, and, to a lesser degree, gastric ulcers. Very recently, H. pylori has also been described in association with gastric lymphoproliferative disease, more specifically low-grade B-cell lymphoma (MALToma) of the stomach, and even gastric non-Hodgkin lymphoma. We report the case of a 14-year-old girl presenting with severe cachexia, abdominal pain, and nausea, who was diagnosed with H. pylori chronic active gastritis and associated gastric lymphoproliferative disease of the low-grade MALT type (as defined by histology and typical gene rearrangements). The patient was treated only for the H. pylori infection (amoxicillin-bismuth-metronidazole triple therapy) without any adjuvant chemotherapy or surgery for her lymphoproliferative disease. The patient was subsequently followed for a period of 7 years with repeated esophago-gastroduodenoscopies with biopsies. There has been no histologic recurrence of H. pylori gastritis or lymphoproliferative disease. To our knowledge, this is the first report of an H. pylori associated gastric lymphoproliferative disorder in a pediatric patient who was exclusively treated for H. pylori infection and subsequently followed for a period of 7 years. Our observations suggest that H. pylori associated gastric lymphoproliferative disease can be completely cured by eradicating the organism. Therefore, this therapeutic approach, combined with close follow-up, should be the treatment of choice in children with this associated condition, before attempting more aggressive treatments, thus potentially avoiding chemotherapy and/or (partial) gastreetomy. PANTOPRAZOLE DOES NOT INTERACT WITH DICLOFENAC. H. Bliesath, R. Huber, .M. Hartmann, V.W. Steinijans, H.J. Koch, W. Wurst. Research Devision Byk Gulden, Konstanz, Germany
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