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Stomach
Acute gastritis with hypochlorhydria: report of 35 cases with long term follow up
  1. W V Harford,
  2. C Barnett,
  3. E Lee,
  4. G Perez-Perez,
  5. M J Blaser,
  6. W L Peterson
  1. 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
  1. Dr W V Harford, DVAMC, 111B1, 4500 South Lancaster Road, Dallas, Texas 75216, USA. Email: wharford{at}worldnet.att.net

Abstract

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 ofHelicobacter pylori in its pathogenesis.

METHODS Archived 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 ofH pylori antibodies, basal and peak acid output, endoscopy, and gastric biopsies. A matched control group underwent the same studies.

RESULTS Archived 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.

CONCLUSIONS One of several possible initial manifestations of H pylori acquisition in adults may be AGH. WhileH pylori colonisation usually persists, hypochlorhydria resolves in most subjects.

  • Helicobacter pylori
  • acute gastritis
  • gastric acid secretion
  • hypochlorhydria

  • Abbreviations used in this paper

    AGH
    acute gastritis with hypochlorhydria
    BAO
    basal acid output
    OGD
    oesophagogastroduodenoscopy
    DU
    duodenal ulcer
    IgG
    immunoglobulin G
    IgM
    immunoglobulin M
    PAO
    peak acid output
    ZES
    Zollinger-Ellison syndrome

    • https://doi.org/10.1136/gut.47.4.467

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    • Abbreviations used in this paper

      AGH
      acute gastritis with hypochlorhydria
      BAO
      basal acid output
      OGD
      oesophagogastroduodenoscopy
      DU
      duodenal ulcer
      IgG
      immunoglobulin G
      IgM
      immunoglobulin M
      PAO
      peak acid output
      ZES
      Zollinger-Ellison syndrome
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