Campylobacter pylori in alcoholic hemorrhagic “gastritis”
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Previously we have shown that alcohol- associated subepithelial hemorrhages histologically represent localized superficial mucosal hemorrhage, with edema in the surrounding mucosa. We studied the relationship between Campylobacter pylori (CP)and histology in gastric subepithelial hemorrhages from 20 actively drinking alcoholic patients. Biopsies of the hemorrhagic lesions and adjacent mucosa 1 and 3 cm away were taken with a “jumbo” forceps. Biopsy slides were coded and randomized before histologic scoring and examination for CP. CP was present in 15/20 (75%)biopsies of subepithelial hemorrhages and in 32/40 (80%)biopsies from surrounding mucosa. The mean hemorrhage score was not significantly different in biopsies of subepithelial hemorrhages with and without CP (2.7±0.4 vs 3.2±0.4)and the edema scores in adjacent, nonhemorrhagic mucosa were similar in specimens with and without CP (2.0±0.3 vs 1.6±0.5).The inflammatory cell density was significantly greater in CP-positive biopsies than in CP-negative specimens (2.0±0.2 vs 0.5±0.2, P<0.05)with the mononuclear cell and neutrophil scores contributing equally to the overall inflammatory cell score. Almost a quarter of CP-positive specimens (11/47)had no inflammation. The mean score for lining epithelial abnormalities was also significantly higher in biopsy specimens positive for CP (1.7±0.2 vs 0.5±0.3, P<0.05).In conclusion, CP is present in 75% of alcohol- associated subepithelial hemorrhages, but its prevalence is similar in adjacent, nonhemorrhagic mucosa. No relationship exists between the presence of CP and the characteristic histologic abnormalities of these subepithelial hemorrhages.
Key wordsCampylobacter pylori alcohol hemorrhage gastritis
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