title: Successful treatment of proton pump inhibitor induced sporadic fundic gland polyps with an argon plasma coagulator in a patient with polycythaemia vera.
abstract: BACKGROUND
  Proton pump inhibitor (PPI) use is associated with the development of fundic gland polyps (FGPs); discontinuing PPIs is associated with regression of FGPs. Here, we report a rare case of non-respondent FGPs after discontinuation of PPI that were successfully treated using an argon plasma coagulator (APC).
  
  
  METHODS
  We present the case of a 68-year-old woman with a history of polycytheamia vera. She also had gastroesophageal reflux disease (GERD) and had been taking 10 mg of omeprazole daily for the past three years. Esophagogastroduedenoscopy (GF) revealed over 100 pedunculated polyps in the gastric body and fundus. Histological examination of the specimens showed dilated oxyntic glands with flattened parietal and mucous cells. Based on these findings and the clinical history, a diagnosis of FGPs was made. Omeprazole use was then discontinued. Repeat GF performed 6 months and 1 year later showed a significant increase in the number and size of the polyps. APC treatment was performed every 6 months for 3 years. Further GF showed a significant decrease in the number and size of the FGPs 4 years after discontinuing PPI.
  
  
  CONCLUSIONS
  We conclude that PPI use is a strong risk factor for the development of FGPs and discontinuing PPI is associated with regression of FGPs, but not in patients with polycythaemia vera. However, the mechanism involved in the interaction between FGP and polycytheamia vera remains unknown.
  
  
  CONCLUSIONS
  Non-respondent FGPs after discontinuation of PPI use may be successfully treated using APC.
authors.affiliation: Department of Surgery, Pippu Clinic, 2-10, 1 chome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido, 078-0343, Japan. Electronic address: pippuclinickato@gold.ocn.ne.jp.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University, 2-5-1, Shikata town, Okayama city, Okayama, 700-8558, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Iwasaki
authors.affiliation: Department of Surgery, Saint Maria Hospital, 442 Fukumoto Town, Kurume City, Fukuoka, 830-8543, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Taniguchi
authors.affiliation: Department of Surgery, Sapporo Hokuyu Hospital, 5-1, 6-6 Higashi- Sapporo, Shiroishi-ku, Sapporo City, 003-0006, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Onodera
authors.affiliation: Department of Surgery, Pippu Clinic, 2-10, 1 chome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido, 078-0343, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Kawakami
authors.affiliation: Department of Surgery, Pippu Clinic, 2-10, 1 chome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido, 078-0343, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuda
authors.affiliation: Department of Surgery, Pippu Clinic, 2-10, 1 chome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido, 078-0343, Japan.
authors.forename: Mineko
authors.initials: M
authors.lastname: Higuchi
authors.affiliation: Department of Surgery, Pippu Clinic, 2-10, 1 chome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido, 078-0343, Japan.
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Surgery, Pippu Clinic, 2-10, 1 chome Nakamachi, Pippu, Town Kamikawa-gun, Hokkaido, 078-0343, Japan.
authors.forename: Yurina
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Pathology, Asahikawa Medical Center, 4048 7 chome, Hanasaki-cho, Asahiwaka City, 070-8644, Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Tamakawa
authors.affiliation: Department of Surgery, Asahikawa Medical University, 1-1, 2-1 Midorigaoka, Asahikawa, 078-8510, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Furukawa
keywords: Proton pump inhibitors (PPI) gastric fundic gland polyp (FGP) TreatmentArgon plasma coagulator (APC) polycythaemia vera