title: Resolution of gastrointestinal protein loss after Helicobacter pylori eradication in a patient with hypertrophic lymphocytic gastritis.
abstract: BACKGROUND
  Lymphocytic gastritis is a rare condition found in approximately 1% of dyspeptic patients. An association with Helicobacter pylori infection has been described. Hypertrophic lymphocytic gastritis is a rare cause of gastrointestinal protein loss. Here, we describe a patient with hypertrophic lymphocytic gastritis, in whom gastrointestinal protein loss resolved completely following H. pylori eradication.
  
  
  METHODS
  A 38-year old obese man without gastrointestinal symptoms showed a markedly decreased serum protein (53 g/l, normal 66-85 g/l), a decreased serum albumin (33 g/l, normal 35-52 g/l) and decreased serum immunoglobulin G and immunoglobulin M levels. A renal cause for protein loss was excluded, liver function was normal. Endoscopy of the upper gastrointestinal tract revealed enlarged rigid gastric folds, and an H. pylori-associated lymphocytic gastritis. 99mTc-labelled albumin scintigraphy showed an increased activity in the upper left abdomen compatible with protein secretion in the stomach, and tracer pooling in the upper small bowel. Push enteroscopy with histology demonstrated a normal upper small bowel. Two months after eradication therapy, cure of H. pylori infection was documented and serum protein (71 g/l) and albumin (41 g/l) had returned to normal, while lymphocytic gastritis was still present. One year after eradication therapy endoscopy of the upper gastrointestinal tract and histology and laboratory values were normal.
  
  
  CONCLUSIONS
  Protein-losing gastropathy caused by H. pylori-associated hypertrophic lymphocytic gastritis can be cured solely by H. pylori eradication therapy.
authors.affiliation: Medical Department I, Technical University Hospital, Dresden, Germany. madisch@mk1.med.tu-dresden.de
authors.forename: Ahmed
authors.initials: A
authors.lastname: Madisch
authors.forename: Daniela
authors.initials: D
authors.lastname: Aust
authors.forename: Andrea
authors.initials: A
authors.lastname: Morgner
authors.forename: Dana
authors.initials: D
authors.lastname: Grossmann
authors.forename: Renate
authors.initials: R
authors.lastname: Schmelz
authors.forename: Joachim
authors.initials: J
authors.lastname: Kropp
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Gustavo
authors.initials: G
authors.lastname: Baretton
authors.forename: Stephan
authors.initials: S
authors.lastname: Miehlke
mesh_terms: D000328:Adult; D001798:Blood Proteins / Q000378:metabolism; D016099:Endoscopy, Gastrointestinal; D005753:Gastric Mucosa / Q000378:metabolism*; D005758:Gastritis, Hypertrophic / Q000188:drug therapy / Q000378:metabolism* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D016480:Helicobacter pylori; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism*; D007677:Kidney Function Tests; D008111:Liver Function Tests; D008297:Male; D011506:Proteins / Q000378:metabolism*; D011860:Radiography, Abdominal
chemical_list: D001798:Blood Proteins; D011506:Proteins