Gastric carcinoids after long‐term use of a proton pump inhibitor
- 5 August 2012
- journal article
- case report
- Published by Wiley in Alimentary Pharmacology & Therapeutics
- Vol. 36 (7), 644-649
- https://doi.org/10.1111/apt.12012
Abstract
Proton pump inhibitors (PPIs) are potent inhibitors of gastric acid secretion and give hypergastrinemia secondary to gastric hypoacidity. PPI treatment therefore induces enterochromaffin-like (ECL) cell hyperplasia. Long-term hypergastrinemia in rodents and man also leads to ECL cell neoplasia. Whether long-term PPI treatment will induce ECL cell neoplasia in man has been disputed. To describe gastric carcinoids in two patients with a history of long-term PPI use. Two patients had been taking PPI for 12-13 years due to gastro-oesophageal reflux disease. At routine upper gastrointestinal endoscopy a solitary tumour was found in the oxyntic mucosa of both patients. Histology from the tumours showed in both cases a well-differentiated neuroendocrine tumour. Biopsies from flat oxyntic mucosa showed no signs of atrophic gastritis and a normal presence of parietal cells in both cases, but hyperplasia of ECL cells. The tumour in patient 1 was resected endoscopically. After cessation of PPI treatment the tumour regressed in patient 2 and the ECL cell hyperplasia regressed in both patients. In patient 2 serum gastrin and chromogranin A were elevated during PPI treatment, and normalised after cessation of treatment. In patient 1, unfortunately, we had serum only after treatment, and at that time both parameters were normal. These cases show that hypergastrinemia secondary to proton pump inhibitors treatment, like other causes of hypergastrinemia, may induce enterochromaffin-like cell carcinoids in man.Keywords
This publication has 21 references indexed in Scilit:
- Parietal cell activation by arborization of ECL cell cytoplasmic projections is likely the mechanism for histamine induced secretion of hydrochloric acidScandinavian Journal of Gastroenterology, 2011
- ECL-Cell Derived Gastric Cancer in Male Cotton Rats Dosed with the H2-Blocker LoxtidineCancer Research, 2004
- Gastrin has a specific proliferative effect on the rat enterochromaffin‐like cell, but not on the parietal cell: A study by elutriation centrifugationActa Physiologica Scandinavica, 2000
- Atrophic gastritis and Helicobacter pylori infection in outpatients referred for gastroscopyGut, 2000
- Gastric Endocrine Cell Proliferation and Fundic Argyrophil Carcinoid Tumors in Patients with the Zollinger-Ellison SyndromeActa Oncologica, 1993
- Gastric Argyrophil Carcinoidosis in Patients with Zollinger-Ellison Syndrome Due to Type 1 Multiple Endocrine NeoplasiaThe American Journal of Surgical Pathology, 1990
- Enterochromaffin-Like Cell Carcinoids of Gastric Mucosa in Rats after Life-Long Inhibition of Gastric SecretionDigestion, 1986
- Twenty-Four Hour Intragastric Acidity during Treatment with Oral OmeprazoleScandinavian Journal of Gastroenterology, 1986
- Association of long lasting unsurmountable histamine H2 blockade and gastric carcinoid tumours in the rat.Gut, 1985