Granulomatous gastritis: a diagnostic dilemma?
Granulomatous inflammation of the gastrointestinal tract is an uncommon entity; an aetiopathogenic diagnosis can be reached only by combining the morphological examination with clinical and laboratory investigations. We report two cases of granulomatous gastritis: a 27-year-old woman presenting with weight loss and a 55-year-old woman presenting with epigastric pain and vomiting. Upper oesophagastroduodenoscopy in these cases showed antral hyperaemia and histopathology showed non-caseating gastric granulomatous inflammation. Both the cases were extensively worked-up for possible tuberculosis (TB) as the patients lived in an endemic area, before starting steroids for the possibility of Crohn's disease (CD) . The first patient improved but the second patient had a flare of underlying undiagnosed TB. Granulomatous gastritis present a diagnostic challenge for treating physicians because of similar clinical, laboratory and endoscopical features between CD and intestinal TB.
Kamani
L
L
Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan. lubna.kamani@aku.edu
Mumtaz
K
K
Azad
N S
NS
Jafri
W
W
D015746:Abdominal Pain / Q000175:diagnosis / Q000628:therapy; D000328:Adult; D001706:Biopsy; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D005756:Gastritis / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D007249:Inflammation; D008875:Middle Aged; D013256:Steroids / Q000627:therapeutic use; D016896:Treatment Outcome; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis / Q000188:drug therapy
D013256:Steroids