Review Article The Other Side of Helicobacter Pylori Infection-Protein-Losing Gastropathy

概要

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Helicobacter pylori (H. pylori) is now regarded as a pathogen for various disease of the gastrointestinal tract. Recent reports indicated that it rarely causes protein loss from the stomach leading to hypoproteinemia, a condition termed as protein-losing gastropathy (PLG). Several conditions are recognized in protein-losing gastropathy caused by H. pylori. Hypertrophic gastropathy with protein-loss, traditionally called Menetrier's disease, is one of manifestations of this condition. This condition may be subdivided in two categories; hypertrophic gastropathy with minimal inflammation and hypertrophic gastritis with giant folds. The latter includes a histological entity termed hypertrophic lymphocytic gastritis. Varioliform gastritis that has characteristic endoscopic features is another entity of the condition showing PLG, which also often shows histological features of lymphocytic gastritis. To our knowledge, lymphocytic gastritis is a rarely seen in Japanese patients. Previously, these conditions were treated with various drugs such as a somatostatin analogue, H2 receptor antagonist, and proton pump inhibitor, resulting in incomplete responses. Recently, a significant number of reports have documented usefulness of eradication therapy for H. pylori. As more than 90 % of patients with gastropathy or gastritis accompanying PLG are positive for H. pylori, treatment of its infection in these patients with PLG is recommended.
長崎大学の論文