Article
Acute gastritis with hypochlorhydria: report of 35 cases with
long term follow up
W V Harford, C Barnett, E Lee, G Perez-Perez, M J Blaser, W L Peterson
Departments of
Internal Medicine, University of Texas Southwestern Medical School,
Dallas, Texas, USA, Vanderbilt University School of Medicine,
Nashville, Tennessee, USA, and Medical Service, Department of Veterans
Affairs Medical Centers at Dallas and Nashville, USA
Correspondence to: Dr W V Harford, DVAMC, 111B1, 4500 South Lancaster Road, Dallas, Texas 75216, USA. Email: wharford{at}worldnet.att.net
Accepted for publication 9 May 2000
BACKGROUND
Between
1976 and 1987, 35 cases of acute gastritis with hypochlorhydria
(AGH) were seen in our research laboratory. The aims of this study were
to determine the natural history of AGH and the role of
Helicobacter pylori in its pathogenesis.
METHODSArchived serum
and gastric biopsy samples obtained from AGH subjects were examined for
evidence of H pylori colonisation. Twenty
eight of 33 (85%) surviving AGH subjects returned a mean of 12 years
after AGH for follow up studies, including determination of
H pylori antibodies, basal and peak acid
output, endoscopy, and gastric biopsies. A matched control group
underwent the same studies.
RESULTSArchived
material provided strong evidence of new H
pylori acquisition in a total of 14 subjects within two months,
in 18 within four months, and in 22 within 12 months of recognition of
AGH. Prevalence of H pylori colonisation at
follow up was 82% (23 of 28) in AGH subjects, significantly (p<0.05)
higher than in matched controls (29%). Basal and peak acid output
returned to pre-AGH levels in all but two subjects.
CONCLUSIONSOne of
several possible initial manifestations of H
pylori acquisition in adults may be AGH. While
H pylori colonisation usually persists,
hypochlorhydria resolves in most subjects.
Keywords: Helicobacter pylori; acute gastritis; gastric acid secretion; hypochlorhydria
© 2000 by Gut
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