title: Effect of Helicobacter pylori eradication on gastric hyperplastic polyposis in Cowden's disease.
abstract: A 21-year-old woman with complaints of hematochezia was diagnosed as having Cowden's disease (CD), an autosomal dominant condition characterized by multiple hamartomas, since facial papules and gingival papillomas were identified. On endoscopy, multiple hyperplastic polyps were seen in the rectum and left-side colon. There were also esophageal glycogenic acanthosis and hyperplastic polyposis in the antrum accompanied by Helicobacter pylori-related gastritis. Although gastric hyperplastic polyposis had by no means regressed with unsuccessful first-line eradication therapy for H pylori, following cure of the infection with salvage therapy consisting of rabeprazole, amoxicillin and metronidazole, the polyposis lesions almost disappeared. Follow-up gastroscopy 2 and 3 years after cessation of the second-line eradication therapy revealed almost complete regression of the polyposis lesions with no evidence of H pylori infection. We recommend eradication treatment for CD patients with gastric hyperplastic polyps and the infection, as the occurrence of gastric carcinoma among hyperplastic polyps has been described.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine 1-7-1 Sakamoto, Nagasaki, Japan. hajimei2002@yahoo.co.jp
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Hisashi
authors.initials: H
authors.lastname: Furusu
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Takehara
authors.forename: Chun-Yang
authors.initials: CY
authors.lastname: Wen
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006223:Hamartoma Syndrome, Multiple / Q000150:complications*; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D006965:Hyperplasia; D011127:Polyps / Q000209:etiology* / Q000382:microbiology* / Q000473:pathology; D013272:Stomach Diseases / Q000209:etiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents