Severe Anemia from Multiple Gastric Hyperplastic Polyps in a Hemodialysis Patient after Long-term Use of a Proton-pump Inhibitor

被引：1
|
作者：
Ikeda, Shiyo [1 ,2 ]
Takahashi, Toshiya [1 ,2 ]
Tandoh, Toshitsugu [3 ]
Ushiyama, Kaori [2 ,4 ]
Kida, Yujiro [1 ,2 ]
机构：
[1] Takashimadaira Chuo Gen Hosp, Dept Nephrol, Tokyo, Japan
[2] Takashimadaira Chuo Gen Hosp, Blood Purificat Ctr, Tokyo, Japan
[3] Takashimadaira Chuo Gen Hosp, Dept Clin Engn, Tokyo, Japan
[4] Takashimadaira Chuo Gen Hosp, Dept Nursing, Tokyo, Japan
来源：
INTERNAL MEDICINE | 2024年 / 63卷 / 05期
关键词：
hemodialysis; severe anemia; gastric bleeding; gastric hyperplastic polyp; proton-pump inhibitor; gastrin; CHRONIC KIDNEY-DISEASE; HELICOBACTER-PYLORI; SERUM GASTRIN; ACID SECRETION; RISK-FACTORS; THERAPY; DISAPPEARANCE; DISCONTINUATION; MANAGEMENT; JAPANESE;
D O I：
10.2169/internalmedicine.2091-23
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
A 90-year-old man on maintenance hemodialysis was admitted due to severe symptomatic anemia. Biopsies under esophagogastroduodenoscopy demonstrated that the cause of anemia was intermittent blood oozing from multiple gastric hyperplastic polyps. Even after successful eradication of Helicobacter pylori, he showed hypergastrinemia (480 pg/mL) owing to esomeprazole (proton-pump inhibitor) therapy for the past 4.5 years to treat reflux esophagitis. Seven months after we switched esomeprazole to famotidine (H2-receptor antagonist), those gastric polyps and anemia were remarkably ameliorated with lowered gastrin levels. This case indicates that long-term use of a proton-pump inhibitor triggers chronic hypergastrinemia, leading to gastric hyperplastic polyps and subsequent severe anemia.
引用
收藏
页码：649 / 657
页数：9
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