title: A case of cap polyposis remission by betamethasone enema after antibiotics therapy including Helicobacter pylori eradication.
abstract: We report the case of a 58-year-old woman who was referred to our hospital due to frequent bloody mucus diarrhea. She was diagnosed with cap polyposis based on typical endoscopic and histological findings. Colonoscopy revealed multiple, reddish, mucus-capped polypoid lesions from the rectum to the sigmoid colon. A pathological examination revealed that the polyps were covered by erosive and inflamed granulation tissue with decreased crypt cells. Laboratory data indicated positive values for Helicobacter pylori immunoglobulin G antibody and hypoproteinemia. Metronidazole, H. pylori eradication, and levofloxacin therapies were not effective; however, the subsequent administration of betamethasone enema dramatically improved the clinical symptoms and endoscopic findings. The hypoproteinemia was normalized after the therapy. The dose of the betamethasone enema was tapered gradually, and no recurrence was observed 6 months after discontinuation of the treatment. This case suggests that betamethasone enema may be considered as the second treatment choice for cap polyposis patients after H. pylori eradication, metronidazole or levofloxacin therapy.
authors.affiliation: Gastrointestinal Endoscopy Division, University of Tsukuba Hospital, Japan. hideoszk@md.tsukuba.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Suzuki
authors.affiliation: Department of Gastroenterology and Hepatology,University of Tsukuba Hospital, Japan Daisuke.
authors.forename: Masashi
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Gastroenterology and Hepatology,University of Tsukuba Hospital, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Akutsu
authors.affiliation: Department of Gastroenterology, Tsukuba Memorial Hospital Tsukuba, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sugiyama
authors.affiliation: Department of Pathology, University of Tsukuba Hospital, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Gastrointestinal Endoscopy Division, University of Tsukuba Hospital, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizokami
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001623:Betamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D003113:Colonoscopy; D004733:Enema; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D044483:Intestinal Polyposis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D001623:Betamethasone