PMID- 28660530
OWN - NLM
STAT- MEDLINE
DCOM- 20180531
LR  - 20181113
IS  - 1865-7265 (Electronic)
IS  - 1865-7257 (Print)
IS  - 1865-7265 (Linking)
VI  - 10
IP  - 5
DP  - 2017 Oct
TI  - Hemorrhagic polyps formed like fundic gland polyps during long-term proton pump 
      inhibitor administration.
PG  - 478-484
LID - 10.1007/s12328-017-0756-x [doi]
AB  - We report a rare case of hemorrhagic gastric polyps resulting in anemia during 
      long-term proton pump inhibitor (PPI) administration that endoscopically looked 
      like a fundic gland polyp (FGP). A 44-year-old man presented complaining of 
      anemia and tarry stools. Esophagogastroduodenoscopy (EGD) demonstrated multiple 
      white edematous polyps in the corpus and antrum, which were considered to be 
      FGPs. We attempted endoscopic hemostasis but hemorrhaging increased because of 
      hemorrhagic polyps and vulnerable gastric mucosa. Re-bleeding occurred several 
      times. Polyp resection was performed at 24 polyp sites. We also ceased the 
      administration of PPI. Microscopically, polyps showed characteristics of 
      hyperplasia in the foveolar epithelium, extensions of fundic glands, and edema of 
      the stroma. The proliferation of parietal and chief cells was also observed. 
      Immunohistochemically, aquaporin-4 (AQP4) and KCNQ1-positive parietal cells and 
      dilated mucous glands were found from the basal side to the apical side of the 
      mucosa. These findings were compatible with the development of lesions associated 
      with the long-term administration of PPI. EGD revealed an improvement in the 
      vulnerability of gastric mucosa and the development of polyps, with no further 
      gastric polyps observed 1 year after discharge. Bleeding from polyps resembling 
      FGPs is generally rare, with indications that long-term PPI administration may 
      induce such bleeding.
FAU - Takeda, Tsutomu
AU  - Takeda T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan. t-takeda@juntendo.ac.jp.
FAU - Asaoka, Daisuke
AU  - Asaoka D
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Tajima, Yuzuru
AU  - Tajima Y
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
AD  - Department of Human Pathology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Matsumoto, Kenshi
AU  - Matsumoto K
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Takeda, Naoto
AU  - Takeda N
AD  - Department of General Medicine, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Hiromoto, Takahumi
AU  - Hiromoto T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Okubo, Shoki
AU  - Okubo S
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Saito, Hiroaki
AU  - Saito H
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Aoyama, Tomonori
AU  - Aoyama T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Shibuya, Tomoyoshi
AU  - Shibuya T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Sakamoto, Naoto
AU  - Sakamoto N
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Hojo, Mariko
AU  - Hojo M
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Osada, Taro
AU  - Osada T
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Nagahara, Akihito
AU  - Nagahara A
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Yao, Takashi
AU  - Yao T
AD  - Department of Human Pathology, Juntendo University School of Medicine, Tokyo, 
      Japan.
FAU - Watanabe, Sumio
AU  - Watanabe S
AD  - Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, 
      Japan.
LA  - eng
GR  - #26460428/a Grant-in-Aid for General Scientific Research from the Ministry of 
      Education, Science, Sports, and Culture/
PT  - Journal Article
DEP - 20170628
PL  - Japan
TA  - Clin J Gastroenterol
JT  - Clinical journal of gastroenterology
JID - 101477246
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Anemia/etiology
MH  - Endoscopy, Digestive System
MH  - Gastrointestinal Hemorrhage/etiology
MH  - Humans
MH  - Hyperplasia
MH  - Male
MH  - Polyps/*chemically induced/complications/*pathology/surgery
MH  - Proton Pump Inhibitors/*adverse effects
MH  - Recurrence
MH  - Stomach Neoplasms/*chemically induced/complications/*pathology/surgery
PMC - PMC5606985
OTO - NOTNLM
OT  - Aquaporin-4
OT  - Bleeding
OT  - Fundic gland polyp
OT  - KCNQ1
OT  - Long-term proton pump inhibitor therapy
OT  - Selective serotonin reuptake inhibitors
COIS- This work was supported in part by a Grant-in-Aid for General Scientific Research 
      from the Ministry of Education, Science, Sports, and Culture (#26460428 to T. 
      Yao), Tokyo, Japan.
EDAT- 2017/07/01 06:00
MHDA- 2018/06/01 06:00
PMCR- 2017/06/28
CRDT- 2017/06/30 06:00
PHST- 2016/09/07 00:00 [received]
PHST- 2017/06/13 00:00 [accepted]
PHST- 2017/07/01 06:00 [pubmed]
PHST- 2018/06/01 06:00 [medline]
PHST- 2017/06/30 06:00 [entrez]
PHST- 2017/06/28 00:00 [pmc-release]
AID - 10.1007/s12328-017-0756-x [pii]
AID - 756 [pii]
AID - 10.1007/s12328-017-0756-x [doi]
PST - ppublish
SO  - Clin J Gastroenterol. 2017 Oct;10(5):478-484. doi: 10.1007/s12328-017-0756-x. 
      Epub 2017 Jun 28.