Severe Anemia from Multiple Gastric Hyperplastic Polyps in a Hemodialysis Patient after Long-term Use of a Proton-pump Inhibitor
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- Ikeda Shiyo
- Department of Nephrology, Takashimadaira Chūō General Hospital, Japan Blood Purification Center, Takashimadaira Chūō General Hospital, Japan
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- Takahashi Toshiya
- Department of Nephrology, Takashimadaira Chūō General Hospital, Japan Blood Purification Center, Takashimadaira Chūō General Hospital, Japan
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- Tandoh Toshitsugu
- Department of Clinical Engineering, Takashimadaira Chūō General Hospital, Japan
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- Ushiyama Kaori
- Blood Purification Center, Takashimadaira Chūō General Hospital, Japan Department of Nursing, Takashimadaira Chūō General Hospital, Japan
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- Kida Yujiro
- Department of Nephrology, Takashimadaira Chūō General Hospital, Japan Blood Purification Center, Takashimadaira Chūō General Hospital, Japan
抄録
<p>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. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 63 (5), 649-657, 2024-03-01
一般社団法人 日本内科学会