RT Journal Article
SR Electronic
T1 Proton Pump Inhibitor Associated Multiple Gastric Hyperplastic Polyps With Uncontrollable Bleeding: A Case Report
JF In Vivo
JO In Vivo
FD International Institute of Anticancer Research
SP 1465
OP 1469
DO 10.21873/invivo.13592
VO 38
IS 3
A1 NAKASHIMA, MASATOSHI
A1 NAOE, HIDEAKI
A1 KOMOHARA, YOSHIHIRO
A1 WAKI, KOTARO
A1 MIYAMOTO, HIDEAKI
A1 SAKAI, YOSHINARI
A1 KOJIMA, TOSHIKI
A1 KANEMITSU, TAKAO
A1 YAO, KENSHI
A1 TANAKA, YASUHITO
YR 2024
UL http://iv.iiarjournals.org/content/38/3/1465.abstract
AB Background/Aim: The long-term use of proton pump inhibitors (PPIs) has been reported to be strongly associated with the development of fundic gland polyps (FGPs). Conversely, a few cases of gastric hyperplastic polyps (GHPs) associated with PPI use have been reported. We experienced a case of PPI-associated multiple GHPs with uncontrollable bleeding. Case Report: A 64 year old man with a history of rheumatoid arthritis presented to the hospital with complaints of vertigo and black stools. Blood tests revealed anemia and hypoproteinemia. Esophagogastroduodenoscopy (EGD) showed blood and black residue accumulated in the stomach. The source of the bleeding was multiple hyperplastic polyps. Bleeding could be stopped even with fasting, and total blood transfusions amounted to 28 units of RBCs were required in 18 days. After the cessation of PPI, EGD showed that the polyps had almost disappeared. Pathological diagnosis of resected polyp was hyperplastic polyp, which was characterized by capillary hyperplasia and edema. Gastrin receptors were over-expressed in the foveolar epithelium and not in the capillaries. Methotrexate (MTX)-induced portal hypertensive gastroenteropathy was revealed during follow-up. We consider that the effect of portal hypertension may have caused the capillary hyperplasia. Conclusion: Although PPI-related polyps are usually fundic gland polyps and do not cause life-threatening adverse events, we experienced PPI-related GHPs in which hemostasis was difficult to control.