Four cases of non-Helicobacter pylori Helicobacter-infected gastritis with duodenal spiral bacilli

IF 4.3 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Helicobacter Pub Date : 2024-04-26 DOI:10.1111/hel.13083

Hiroyuki Agawa, Toshihisa Tsukadaira, Natsuko Kobayashi, Himiko Kodaira, Hiroyoshi Ota, Takehisa Matsumoto, Kazuki Horiuchi, Tatsuya Negishi, Toshifumi Tada

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Abstract

Background

Non-Helicobacter pylori Helicobacter (NHPH) is rarely detected in duodenal mucosa due to its preference for slightly acidic environments. Here, we report four cases of NHPH-infected gastritis with duodenal spiral bacilli, potentially NHPH, indicating the possibility of duodenal mucosal infection.

Case Presentation

In every case, gastric mucosa showed endoscopic findings characteristic of NHPH-infected gastritis, and a mucosal biopsy was taken from the duodenal bulb; spiral bacilli were identified under microscopy using Giemsa staining. Case 1, a 46-year-old man, had diffuse spotty redness, mucosal edema, and multiple tiny erosions in the duodenal bulb, along with larger erosions in the second portion of the duodenum upon endoscopic examination. Histopathologically, moderate infiltration of mononuclear cells and neutrophils in the lamina propria and gastric epithelial metaplasia were observed. Case 2, a 54-year-old man, showed an elevated lesion, 1 cm in diameter, with multiple red spots and a few tiny erosions in the duodenal bulb. Histopathologically, mild inflammatory cell infiltration and gastric epithelial metaplasia were observed. In Case 3, a 52-year-old man, endoscopy revealed a flat elevated lesion, 7 mm in diameter, with multiple red spots and a few tiny erosions in the anterior wall of the duodenal bulb. Histopathologically, we observed moderate inflammatory cell infiltration in the gastric antrum and gastric epithelial metaplasia in the duodenal bulb. Case 4, a 40-year-old man, showed mild spotty redness in the duodenal bulb. Histopathologically, mild mononucleocyte infiltration and gastric epithelial metaplasia were observed. A single spiral bacillus was observed in Case 4 by microscopy. In all but Case 2, Helicobacter suis was identified in the gastric juice by polymerase chain reaction analysis.

Conclusions

Spiral bacilli resembling NHPH may infect the duodenal mucosa, particularly the bulb, causing inflammation. Gastric contents entering the duodenum may reduce the intraduodenal pH, promoting NHPH survival and proliferation.

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四例十二指肠螺旋杆菌感染的非幽门螺旋杆菌胃炎病例

背景非幽门螺旋杆菌（NHPH）由于喜欢微酸性环境，很少在十二指肠粘膜中被发现。在此，我们报告了四例 NHPH 感染性胃炎病例，其十二指肠螺旋杆菌可能是 NHPH，这表明十二指肠粘膜感染的可能性很大。病例表现每个病例的胃黏膜都显示出 NHPH 感染性胃炎的内镜特征，并从十二指肠球部取黏膜活检；使用 Giemsa 染色法在显微镜下鉴定出螺旋状杆菌。病例 1 是一名 46 岁的男性，内镜检查时发现十二指肠球部弥漫性点状发红、粘膜水肿和多处微小糜烂，十二指肠的第二部分也有较大糜烂。组织病理学检查发现，固有层有中度的单核细胞和中性粒细胞浸润，胃上皮变性。病例 2 是一名 54 岁的男性，十二指肠球部有一个直径 1 厘米的隆起病灶，病灶上有多个红点和一些微小的糜烂。组织病理学观察到轻度炎性细胞浸润和胃上皮化生。病例 3 是一名 52 岁的男性，内镜检查发现十二指肠球部前壁有一个扁平隆起的病变，直径 7 毫米，有多个红点和一些微小的糜烂。组织病理学检查发现，胃窦部有中度炎症细胞浸润，十二指肠球部有胃上皮化生。病例 4：40 岁男性，十二指肠球部轻度点状发红。组织病理学观察到轻度单核细胞浸润和胃上皮化生。病例 4 在显微镜下观察到一个螺旋状杆菌。通过聚合酶链反应分析，除病例 2 外，其他病例的胃液中都发现了猪螺旋杆菌。结论类似于 NHPH 的螺旋杆菌可能会感染十二指肠粘膜，尤其是球部，从而引起炎症。进入十二指肠的胃内容物可能会降低十二指肠内的 pH 值，促进 NHPH 的存活和增殖。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.