ANTRAL NODULARITY, GASTRIC LYMPHOID HYPERPLASIA, AND HELICOBACTER-PYLORI IN ADULTS

Our objective is to evaluate endoscopically-diagnosed antral nodularit y in adults and its relationship to lymphoid hyperplasia (LH) and Heli cobacter pylon (HP). Antral biopsy specimens were studied for inflamma tion, presence of HP, and lymphoid follicles. Patients with marked fun ctional dyspepsia or recurrent duodenal ulcers were given triple thera py (bismuth subcitrate, tetracycline, and metronidazole in the recomme nded doses for 2 weeks) to eradicate HP. Follow-up endoscopy and biops ies, at least 4 weeks after finishing treatment, were performed to ass ess eradication of HP and its effect on nodularity and LH. In all 25 p atients (age range, 20-42 years) with antral nodularity, biopsy specim ens were positive for HP. Twenty (80%) of subjects had lymphoid follic les; 13 of these 20 were given triple therapy. Eradication of HP was a chieved in five cases (38%). Patients in whom HP was successfully erad icated showed improvement of their symptoms; antral nodularity subside d and there was marked regression of the lymphoid follicles. Antral no dularity with LH, reported to be unique to children, is not uncommon i n adults and is induced by HP, eradication of which leads to regressio n of nodularity and LH in most cases. Low eradication rates achieved w ith metronidazole-based triply therapy is due, possibly, to primary re sistance to metronidazole. Long-term follow-up of such patients is req uired to assess the evolution of these findings.