A case of idiopathic granulomatous gastritis with various endoscopic findings

Abstract

A 62-year-old woman came to our hospital with complaint of epigastralgia for one month. Upper gastrointestinal endoscopy showed scattered nodular lesions 5mm in size in the fornix. Biopsy specimens obtained from the nodular lesions revealed non-caseating granuloma with infiltration of inflammatory cells. One month later, endoscopic examination showed multiple yellowish discolored lesions in the region of greater curvature of the body, and biopsy specimens obtained from the discolored lesion also revealed non-caseating granuloma, H. pylori urea breath test was negative, but serum anti-HP antibody was positive. No definite etiologic factors such as systemic sarcoidosis, Crohn's disease, tuberculosis could be detected. Several reports suggested close relationship between idiopathic granulomatous gastritis and H. pylori, whereas it is not clear in our case. Idiopathic granulomatous gastritis has been rarely reported in Japan. Further clinical investigation of the cases of idiopathic granulomatous gastritis is necessary for clarifying the pathogenesis of the disease.