Idiopathic granulomatous gastritis with multiple aphthoid ulcers

A 47-year-old woman had idiopathic granulomatous gastritis characterized by serpiginous aphthoid ulcer with satellite aphthous ulcers at the antrum to angulus with noncaseating epithelioid granulomas including giant cells in the gastric mucosa. No definite etiologic factors could be detected; systemic sarcoidosis, Crohn's disease, infections (tuberculosis, syphilis and fungus), neoplasm, and foreign body reaction were excluded by additional investigations. However, the patient was found to be infected with H. pylori. Despite the success of H. pylori-eradication, the granulomatous lesion took a long time to heal for at least 17 months or more. The relation between granulomatous gastritis and H. pylori was discussed. There was no apparent evidence of granuloma in the other organs during clinical and follow-up studies for over three years.