Resolution of Helicobacter pylori-associated gastric lymphoproliferative disease in a child.
A possible causative association between Helicobacter pylori infection and gastric lymphoproliferative disorders has recently been recognized. The case of a 14-year-old girl who was diagnosed with H. pylori gastritis and associated gastric lymphoproliferative disease of the low-grade mucosa-associated lymphoid tissue type is reported. The patient was treated only for the H. pylori infection (amoxicillin, bismuth, and metronidazole) without any adjuvant chemotherapy or surgery for her lymphoproliferative disorder. This treatment not only resulted in the eradication of the microorganism but also complete resolution of her lymphoproliferative disease. The patient was subsequently followed up for a period of 7 years. There has been no histological recurrence of H. pylori gastritis or gastric lymphoproliferative disease. It is believed that this is the first report to describe a long-term follow-up of an H. pylori-associated gastric lymphoproliferative disorder in a pediatric patient who was exclusively treated for H. pylori infection. The observations in this report suggest that H. pylori-associated low-grade 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) gastrectomy.
Blecker
U
U
Department of Pediatrics, Pritzker School of Medicine, Wyler Children's Hospital, University of Chicago, Illinois, USA.
McKeithan
T W
TW
Hart
J
J
Kirschner
B S
BS
D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000150:complications* / Q000188:drug therapy; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy / Q000209:etiology*; D008795:Metronidazole / Q000627:therapeutic use; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000209:etiology*
D008795:Metronidazole; D000658:Amoxicillin; D001729:Bismuth