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European Journal of Case Reports in... 2022A 71-year-old female presented with 5 days of diarrhoea and asthenia. Past medical history of rheumatoid arthritis, arterial hypertension, hypertrophic cardiomyopathy...
UNLABELLED
A 71-year-old female presented with 5 days of diarrhoea and asthenia. Past medical history of rheumatoid arthritis, arterial hypertension, hypertrophic cardiomyopathy and chronic gastritis was treated with leflunomide, deflazacort, esomeprazole, carvedilol and spironolactone. At admission, the patient's physical examination showed signs of dehydration. Lab results revealed leucocytosis, increased C-reactive protein, hypomagnesaemia, hypocalcaemia and hypokalaemia. A presumption of acute infectious diarrhoea causing hypomagnesaemia with hypocalcaemia and hypokalaemia was made. She was started on ciprofloxacin, IV hydration and electrolyte supplementation with an adequate response. However, magnesium levels fell repeatedly. After excluding other causes for hypomagnesaemia, chronic use of proton pump inhibitors (PPIs) was considered a plausible cause therefore PPI was discontinued, with normalisation of magnesium levels. Hypomagnesaemia is a common disturbance, mainly caused by diarrhoea, gastrointestinal malabsorption, medications, alcoholism and volume expansion. Clinical manifestations include neuromuscular symptoms, cardiovascular manifestations, hypokalaemia and changes in calcium metabolism. PPI-related hypomagnesaemia has been described in later years particularly in chronic use cases, with a medium prevalence of 27%, but further studies remain necessary to clarify its pathophysiologic mechanism. Since PPIs are widely used, it is essential to be aware of hypomagnesaemia as a possible side effect, particularly in refractory cases and after excluding other common causes.
LEARNING POINTS
PPIs-related hypomagnesaemia should be a concern, especially in cases with refractory hypomagnesaemia and after excluding other common causes.Formal indication for PPIs use should be revised in most patients.
PubMed: 36506733
DOI: 10.12890/2022_003637 -
British Medical Journal (Clinical... Nov 1985
Topics: Diagnosis, Differential; Female; Gastritis, Hypertrophic; Humans; Hyperplasia; Male; Stomach
PubMed: 3933641
DOI: 10.1136/bmj.291.6505.1298 -
Gut Jan 2007
Topics: Gastritis, Hypertrophic; Helicobacter Infections; Helicobacter pylori; Humans
PubMed: 17172596
DOI: No ID Found -
Gut Jun 1995
Topics: Gastritis, Hypertrophic; Helicobacter Infections; Helicobacter pylori; Humans; Terminology as Topic
PubMed: 7615294
DOI: 10.1136/gut.36.6.945-a -
Gut and Liver Nov 2023: Accurately diagnosing diffuse gastric wall thickening is challenging. Hypertrophic gastritis (HG), while benign, mimics the morphology of Borrmann type 4 advanced...
BACKGROUND/AIMS
: Accurately diagnosing diffuse gastric wall thickening is challenging. Hypertrophic gastritis (HG), while benign, mimics the morphology of Borrmann type 4 advanced gastric cancer (AGC B-4). We compared the features of endoscopy and endoscopic ultrasonography (EUS) between them.
METHODS
: We retrospectively reviewed patients who underwent EUS for gastric wall thickening between 2000 and 2021, selecting HG and pathologically confirmed advanced gastric cancer cases. Ulceration and antral wall thickening were determined via endoscopy, while EUS assessed the 5-layered gastric wall structure, measuring the proper muscle (PM) layer and total wall thickness.
RESULTS
: Male dominance was observed in AGC B-4, and the hemoglobin and albumin levels were significantly lower. The rate of antral wall thickening and presence of ulceration were significantly higher in AGC B-4 cases. Destruction of the PM layers was observed only in AGC B-4 cases, and the PM was significantly thicker in AGC B-4 cases. Forceps biopsy had an excellent success rate in ulcer-present AGC B-4 cases, but only a 42.6% success rate was observed for cases without ulcers, necessitating additional diagnostic modalities. A PM thickness of 2.39 mm distinguished between AGC B-4 and HG effectively. The multivariable analysis showed that a thickened PM layer and the presence of ulceration were significant risk factors for the diagnosis of AGC B-4.
CONCLUSIONS
: Endoscopic findings of a thickened gastric wall, including antral involvement, and presence of ulcer were significant risk factors for the diagnosis of AGC B-4. EUS findings of destroyed wall layers and a thickened PM of >2.39 mm were the key points of differentiation between HG and AGC B-4.
PubMed: 38013478
DOI: 10.5009/gnl230307 -
Transactions of the American Clinical... 2012In 1888, Pierre Ménétrier first described the disease that bears his name. Many of the findings he reported then remain accepted features of the disease. Based on... (Review)
Review
In 1888, Pierre Ménétrier first described the disease that bears his name. Many of the findings he reported then remain accepted features of the disease. Based on studies performed in our laboratory over the past 20 years, we have implicated increased transforming growth factor-α (TGFα) expression and heightened epidermal growth factor receptor (EGFR) activity in the pathogenesis of Ménétrier's disease. Herein, we provide a historical perspective of this rare disorder, review our experience with Ménétrier's disease, and discuss future challenges and opportunities posed by this disorder.
Topics: ErbB Receptors; France; Gastritis, Hypertrophic; History, 19th Century; History, 20th Century; History, 21st Century; Transforming Growth Factor alpha
PubMed: 23303980
DOI: No ID Found -
Gut Mar 2004
Topics: Adult; Diagnosis, Differential; Gastric Mucosa; Gastritis, Hypertrophic; Gastroscopy; Humans; Male
PubMed: 14960509
DOI: 10.1136/gut.2003.029876 -
Annals of Surgery May 1952
Topics: Gastritis; Gastritis, Hypertrophic; Humans
PubMed: 14924519
DOI: 10.1097/00000658-195205000-00008 -
Proceedings of the Royal Society of... Jan 1948
Topics: Gastritis; Gastritis, Hypertrophic; Humans; Inflammation; Stomach
PubMed: 18933848
DOI: No ID Found