Közleményünkben egy protonpumpagátló kezeléssel összefüggésben kialakult, táplálkozási nehezítettség miatt teljes gastrectomiához vezető, továbbá egy passzázszavart még nem okozó masszív fundusmirigy-polyposis esetét mutatjuk be, emellett irodalmi áttekintést adunk az elváltozás gyakoriságáról és kialakulásának hátteréről, és ennek kapcsán röviden összefoglaljuk a protonpumpagátló kezelés és egyéb makro- és mikromorfológiai gastricus eltérések esetleges kapcsolatát vizsgáló tanulmányok eredményeit. A gastrectomiához vezető masszív fundusmirigy-polyposis a tartós protonpumpagátló kezelés ritka szövődménye, saját esetünk a második közölt a világon, de a terápia elterjedtsége miatt ennek gyakoribbá válása várható. Orv. Hetil., 2012, 153, 351–356.
Raghunath, A. S., O’Morain, C., McLoughlin, R. C.: Review article: the long-term use of proton pump inhibitors. Aliment. Pharmacol. Ther., 2005, 22 (Suppl. 1), 55–63.
McLoughlin R. C. , 'Review article: the long-term use of proton pump inhibitors ' (2005 ) 22 Aliment. Pharmacol. Ther. : 55 -63 .
Graham, J. R.: Gastric polyposis: onset during long-term therapy with omeprazole. Med. J. Aust., 1992, 157, 287–288.
Graham J. R. , 'Gastric polyposis: onset during long-term therapy with omeprazole ' (1992 ) 157 Med. J. Aust. : 287 -288 .
Jalving, M., Koornstra, J. J., Wesseling, J., et al.: Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy. Aliment. Pharmacol. Ther., 2006, 24, 1341–1348.
Wesseling J. , 'Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy ' (2006 ) 24 Aliment. Pharmacol. Ther. : 1341 -1348 .
Vieth, M., Stolte, M.: Fundic gland polyps are not induced by proton pump inhibitor therapy. Am. J. Clin. Pathol., 2001, 116, 716–720.
Stolte M. , 'Fundic gland polyps are not induced by proton pump inhibitor therapy ' (2001 ) 116 Am. J. Clin. Pathol. : 716 -720 .
Choundry, U., Boyce, H. W. Jr., Coppola, D.: Proton pump inhibitor-associated gastric polyps. A retrospective analysis of their frequency, and endoscopic, histologic and ultrastructural characteristics. Am. J. Clin. Pathol., 1998, 110, 615–621.
Coppola D. , 'Proton pump inhibitor-associated gastric polyps. A retrospective analysis of their frequency, and endoscopic, histologic and ultrastructural characteristics ' (1998 ) 110 Am. J. Clin. Pathol. : 615 -621 .
Freeman, H. J.: Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis. World. J. Gastroenterol., 2008, 14, 1318–1320.
Freeman H. J. , 'Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis ' (2008 ) 14 World. J. Gastroenterol. : 1318 -1320 .
Iida, M., Yao, T., Watanabe, H., et al.: Spontaneous disappearance of fundic gland polyposis: report of three cases. Gastroenterology, 1980, 79, 725–728.
Watanabe H. , 'Spontaneous disappearance of fundic gland polyposis: report of three cases ' (1980 ) 79 Gastroenterology : 725 -728 .
Ally, M. R., Veerappan, G. R., Maydonovitch, C. L., et al.: Chronic proton pump inhibitor therapy associated with increased development of fundic gland polyps. Dig. Dis. Sci., 2009, 54, 2617–2622.
Maydonovitch C. L. , 'Chronic proton pump inhibitor therapy associated with increased development of fundic gland polyps ' (2009 ) 54 Dig. Dis. Sci. : 2617 -2622 .
Oberhuber, G., Stolte, M.: Gastric polyps: an update of their pathology and biological significance. Virchows Arch., 2000, 437, 581–590.
Stolte M. , 'Gastric polyps: an update of their pathology and biological significance ' (2000 ) 437 Virchows Arch. : 581 -590 .
Odze, R. D., Marcial, M. A., Antonioli, D.: Gastric fundic gland polyps: a morphological study including mucin histochemistry, stereometry, and mib-1 immunhistochemistry. Hum. Pathol., 1996, 27, 896–903.
Antonioli D. , 'Gastric fundic gland polyps: a morphological study including mucin histochemistry, stereometry, and mib-1 immunhistochemistry ' (1996 ) 27 Hum. Pathol. : 896 -903 .
Abraham, S. C., Nobukawa, B., Giardiello, F. M., et al.: Fundic gland polyps in familial adenomatous polyposis. Neoplasms with frequent somatic adenomatous polyposis coli gene alterations. Am. J. Pathol., 2000, 157, 747–754.
Giardiello F. M. , 'Fundic gland polyps in familial adenomatous polyposis. Neoplasms with frequent somatic adenomatous polyposis coli gene alterations ' (2000 ) 157 Am. J. Pathol. : 747 -754 .
Marcial, M. A., Villafaña, M., Hernandez-Denton, J., et al.: Fundic gland polyps: prevalence and clinicopathologic features. Am. J. Gastroenterol., 1993, 88, 1711–1713.
Hernandez-Denton J. , 'Fundic gland polyps: prevalence and clinicopathologic features ' (1993 ) 88 Am. J. Gastroenterol. : 1711 -1713 .
Zelter, A., Fernández, J. L., Bilder, C., et al.: Fundic gland polyps and association with proton pump inhibitor intake: a prospective study in 1,780 endoscopies. Dig. Dis. Sci., 2011, 56, 1743–1748.
Bilder C. , 'Fundic gland polyps and association with proton pump inhibitor intake: a prospective study in 1,780 endoscopies ' (2011 ) 56 Dig. Dis. Sci. : 1743 -1748 .
Lee, R. G., Burt, R. W.: The histopathology of fundic gland polyps of the stomach. Am. J. Clin. Pathol., 1986, 86, 498–503.
Burt R. W. , 'The histopathology of fundic gland polyps of the stomach ' (1986 ) 86 Am. J. Clin. Pathol. : 498 -503 .
Iida, M., Yao, T., Watanabe, H., et al.: Fundic gland polyposis in patients without familial adenomatosis coli: its incidence and clinical features. Gastroenterology, 1984, 86, 1437–1442.
Watanabe H. , 'Fundic gland polyposis in patients without familial adenomatosis coli: its incidence and clinical features ' (1984 ) 86 Gastroenterology : 1437 -1442 .
Burt, R. W.: Gastric fundic gland polyps. Gastroenterology, 2003, 125, 1462–1469.
Burt R. W. , 'Gastric fundic gland polyps ' (2003 ) 125 Gastroenterology : 1462 -1469 .
Rubio, C. A., Befrits, R., Österberg, J., et al.: Massive fundic gland polyposis in a patient receiving protracted proton-pump inhibitor medication. Anticancer. Res., 2010, 30, 261–264.
Österberg J. , 'Massive fundic gland polyposis in a patient receiving protracted proton-pump inhibitor medication ' (2010 ) 30 Anticancer. Res. : 261 -264 .
Torbenson, M., Lee, J-H., Cruz-Correa, M. és mtsai: Sporadic fundic gland polyps: a clinical, histological and molecular analysis. Mod. Pathol., 2002, 15, 718–723.
Cruz-Correa M. , 'Sporadic fundic gland polyps: a clinical, histological and molecular analysis ' (2002 ) 15 Mod. Pathol. : 718 -723 .
Hizawa, K., Iida, M., Matsumoto, T., et al.: Natural history of fundic gland polyposis without familial adenomatosis coli: follow-up observations in 31 patients. Radiology, 1993, 189, 429–432.
Matsumoto T. , 'Natural history of fundic gland polyposis without familial adenomatosis coli: follow-up observations in 31 patients ' (1993 ) 189 Radiology : 429 -432 .
Abraham, S. C., Park, S. J., Mugartegui, L., et al.: Sporadic fundic gland polyps with epithelial dysplasia. Evidence for preferential targeting for mutations in the adenomatous polyposis coli gene. Am. J. Pathol., 2002, 161, 1735–1742.
Mugartegui L. , 'Sporadic fundic gland polyps with epithelial dysplasia. Evidence for preferential targeting for mutations in the adenomatous polyposis coli gene ' (2002 ) 161 Am. J. Pathol. : 1735 -1742 .
Abraham, S. C., Nobukawa, B., Giardiello, F. M., et al.: Sporadic fundic gland polyps. Common gastric polyps arising through activating mutations in the β-catenin gene. Am. J. Pathol., 2001, 158, 1005–1010.
Giardiello F. M. , 'Sporadic fundic gland polyps. Common gastric polyps arising through activating mutations in the β-catenin gene ' (2001 ) 158 Am. J. Pathol. : 1005 -1010 .
Jalving, M., Koornstra, J. J., Götz, J. M., et al.: High grade dysplasia in sporadic fundic gland polyps: a case report and a review of the literature. Eur. J. Gastroenterol. Hepatol., 2003, 15, 1229–1233.
Götz J. M. , 'High grade dysplasia in sporadic fundic gland polyps: a case report and a review of the literature ' (2003 ) 15 Eur. J. Gastroenterol. Hepatol. : 1229 -1233 .
Attard, T. M., Yardley, J. H., Cuffari, C.: Gastric polyps in pediatrics: an 18-year hospital-based analysis. Am. J. Gastroenterol., 2002, 97, 298–301.
Cuffari C. , 'Gastric polyps in pediatrics: an 18-year hospital-based analysis ' (2002 ) 97 Am. J. Gastroenterol. : 298 -301 .
Stolte, M., Vieth, M., Ebert, M. P. A.: High grade dysplasia in sporadic fundic gland polyps: clinically releavant or not? Eur. J. Gastroenterol. Hepatol., 2003, 15, 1153–1156.
Ebert M. P. A. , 'High grade dysplasia in sporadic fundic gland polyps: clinically releavant or not? ' (2003 ) 15 Eur. J. Gastroenterol. Hepatol. : 1153 -1156 .
Kuipers, E. J.: Proton pump inhibitors and gastric neoplasia. Gut, 2006, 55, 1217–1221.
Kuipers E. J. , 'Proton pump inhibitors and gastric neoplasia ' (2006 ) 55 Gut : 1217 -1221 .
Hornick, J. L., Odze, R. D.: Adenomatous polyposis syndrome. In: Surgical pathology of the GI tract, liver, biliary tract and pancreas. Second edition (Chapter 19: Polyps of the large intestine). Eds.: Odze, R. D., Goldblum, J. R. Elsevier Inc., 2009, 514–516.
Odze R. D. , '', in Surgical pathology of the GI tract, liver, biliary tract and pancreas , (2009 ) -.
Driman, D. K., Wright, C., Tougas, G., et al.: Omeprazole produces parietal cell hypertrophy and hyperplasia in humans. Dig. Dis. Sci., 1996, 41, 2039–2047.
Tougas G. , 'Omeprazole produces parietal cell hypertrophy and hyperplasia in humans ' (1996 ) 41 Dig. Dis. Sci. : 2039 -2047 .
Lee, S. W., Lieberman, D. A., Ippoliti, A. F., et al.: Changes in the parietal cell mass after long term therapy with high dose omeprazole in Barrett’s esophagus (BE): a two year prospective study. Gastroenterology, 1996, 110, A17.
Ippoliti A. F. , 'Changes in the parietal cell mass after long term therapy with high dose omeprazole in Barrett’s esophagus (BE): a two year prospective study ' (1996 ) 110 Gastroenterology : A17 -.
Cats, A., Schenk, B. E., Bloemena, E., et al.: Parietal cell protrusions and fundic gland cysts during omeprazole maintenance treatment. Hum. Pathol., 2000, 31, 684–690.
Bloemena E. , 'Parietal cell protrusions and fundic gland cysts during omeprazole maintenance treatment ' (2000 ) 31 Hum. Pathol. : 684 -690 .
Synnerstad, I., Holm, L.: Omeprazole induces high intraglandular pressure in the rat gastric mucosa. Gastroenterology, 1997, 112, 1221–1230.
Holm L. , 'Omeprazole induces high intraglandular pressure in the rat gastric mucosa ' (1997 ) 112 Gastroenterology : 1221 -1230 .
Solcia, E., Fiocca, R., Havu, N., et al.: Gastric endocrine cells and gastritis in patients receiving long-term omeprazole treatment. Digestion, 1992, 51 (Suppl 1), 82–92.
Havu N. , 'Gastric endocrine cells and gastritis in patients receiving long-term omeprazole treatment ' (1992 ) 51 Digestion : 82 -92 .
Klinkenberg-Knol, E. C., Nelis, F., Dent, J., et al.: Long-term omeprazole treatment in resistant gastroesophageal reflux disease: efficacy, safety, and influence on gastric mucosa. Gastroenterology, 2000, 118, 661–669.
Dent J. , 'Long-term omeprazole treatment in resistant gastroesophageal reflux disease: efficacy, safety, and influence on gastric mucosa ' (2000 ) 118 Gastroenterology : 661 -669 .
Stolte, M., Meining, A., Schmitz, J. M., et al.: Changes in Helicobacter pylori-induced gastritis in the antrum and corpus during 12 months of treatment with omeprazole and lansoprazole in patient with gastro-oesophageal reflux disease. Aliment. Pharmacol. Ther., 1998, 12, 247–253.
Schmitz J. M. , 'Changes in Helicobacter pylori-induced gastritis in the antrum and corpus during 12 months of treatment with omeprazole and lansoprazole in patient with gastro-oesophageal reflux disease ' (1998 ) 12 Aliment. Pharmacol. Ther. : 247 -253 .
Kuipers, E. J., Lundell, L., Klinkenberg-Knol, E. C., et al.: Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication. N. Engl. J. Med., 1996, 304, 1018–1022.
Klinkenberg-Knol E. C. , 'Atrophic gastritis and Helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication ' (1996 ) 304 N. Engl. J. Med. : 1018 -1022 .
Kuipers, E. J., Nelis, G. F., Klinkenberg-Knol, E. C., et al.: Cure of Helicobacter pylori infection in patients with reflux esophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial. Gut, 2004, 53, 12–20.
Klinkenberg-Knol E. C. , 'Cure of Helicobacter pylori infection in patients with reflux esophagitis treated with long term omeprazole reverses gastritis without exacerbation of reflux disease: results of a randomised controlled trial ' (2004 ) 53 Gut : 12 -20 .
Malfertheiner, P., Megraud, F., O’Morain, C., et al., The European Helicobacter Study Group (EHSG): Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut, 2007, 56, 772–781.
O’Morain C. , 'Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report ' (2007 ) 56 Gut : 772 -781 .
Panter, S. J., O’Flanagan, H., Bramble, M. G., et al.: Empirical use of antisecretory drug therapy delays diagnosis of upper gastrointestinal adenocarcinoma but does not effect outcome. Aliment. Pharmacol. Ther., 2004, 19, 981–988.
Bramble M. G. , 'Empirical use of antisecretory drug therapy delays diagnosis of upper gastrointestinal adenocarcinoma but does not effect outcome ' (2004 ) 19 Aliment. Pharmacol. Ther. : 981 -988 .
Bramble, M. G., Suvakovic, Z., Hungin, A. P. S.: Detection of upper gastrointestinal cancer in patients taking antisecretory therapy prior to gastroscopy. Gut, 2000, 46, 464–467.
Hungin A. P. S. , 'Detection of upper gastrointestinal cancer in patients taking antisecretory therapy prior to gastroscopy ' (2000 ) 46 Gut : 464 -467 .
Jacobson, B. C., Ferris, T. G., Shea, T. L., et al.: Who is using chronic acid suppression therapy and why? Am. J. Gastroenterol., 2003, 98, 51–58.
Shea T. L. , 'Who is using chronic acid suppression therapy and why? ' (2003 ) 98 Am. J. Gastroenterol. : 51 -58 .
Pap, Á.: Side effects of long-term treatment with proton pump inhibitors [A hosszú távú protonpumpagátló kezelés mellékhatásai.]. LAM, 2009, 19, 489–492.
Pap Á. , 'Side effects of long-term treatment with proton pump inhibitors [A hosszú távú protonpumpagátló kezelés mellékhatásai.] ' (2009 ) 19 LAM : 489 -492 .