GASTROSPIRILLUM-HOMINIS (HELICOBACTER-HEILMANII) - A CAUSE OF GASTRITIS, SOMETIMES TRANSIENT, BETTER DIAGNOSED BY TOUCH CYTOLOGY

Objective: Besides Helicobacter pylori, another spirillar microorganis m, provisionally called Gastrospirillum hominis, has been described in the human stomach in association with gastritis. The aim of this stud y was to assess the role of cytology in the diagnosis, to assess the g astritis associated with this infection, and to approach its natural h istory. Methods: Charts and endoscopic biopsies and smears (touch cyto logy) from 28 patients with G. hominis seen between 1986 and 1992 were reviewed and compared with biopsies and smears from 28 patients with H, pylori gastritis. Results: G. hominis was seen on smears from all 2 8 patients but diagnosed in only 15 of the corresponding sets of biops ies. No patient had evidence of H. pylori colonization. All patients h ad chronic antral gastritis with lymphoplasmocytes, and neutrophils we re present in 13 patients. In addition, reactive changes were frequent : foveolar hyperplasia (n = 25), vasodilation (n = 23), lamina propria edema (n = 23), and increased intracytoplasmic mucin (n = 19). In con trast, intestinal metaplasia (n = 3) and glandular atrophy (n = 2) wer e infrequent, and lymphoid nodules were not seen, In patients with H. pylori, reactive changes were mild, and the lymphoplasmocytic infiltra tion was more intense (p < 0.005). Eleven patients had at least two en doscopic examinations with biopsies, with persistent colonization in o nly four. Seven patients cleared the infection with a concomitant regr ession of gastritis. Conclusions: G. hominis is more often detected in smears than biopsies. It is seen in association with a peculiar form of gastritis-associating chronic and reactive changes. Colonization ma y be a transient phenomenon and is never associated with H. pylori.