Regression of primary gastric B-cell mucosa-associated lymphoid tissue (MALT) lymphoma after eradication of Helicobacter pylori.

OBJECTIVE: primary gastric B-cell lymphoma of the mucosa-associated lymphoid tissue type has been linked to infection of the gastric mucosa with Helicobacter pylori. The eradication of this pathogen with antibiotics can lead to regression of this type of lymphoma. The objective of this study was to describe the clinical, endoscopic and histologic evolution in 6 patients with primary gastric B-cell lymphoma of the mucosa-associated lymphoid tissue type treated with eradication of H. pylori. METHOD: descriptive study of a retrospective case series. Patients with low-grade gastric mucosa-associated lymphoid tissue type lymphoma were initially treated with eradication therapy for H. pylori. We evaluated their clinical, endoscopic and histologic course in sequential follow-up visits after initial therapy. RESULTS: six patients who satisfied all selection criteria were studied. In five of six patients H. pylori was eradicated and the lymphoma showed regression within 6 to 24 months. In one patient transition of low-grade to high-grade gastric lymphoma occurred. CONCLUSIONS: these results, along with similar findings from other studies, suggest eradication of H. pylori should be the initial treatment of choice for low-grade B-cell gastric mucosa-associated lymphoid tissue type lymphoma in the early stages. The most appropriate duration of follow-up is unknown, but prolonged follow-up is indicated to detect recurrences.

[Intravenous 3-day Helicobacter pylori eradication therapy is highly effective in patients with bleeding peptic ulcer]. / Alta eficacia erradicadora de la infección por Helicobacter pylori de una pauta terapéutica intravenosa de 3 días de duración en pacientes con úlcera péptica sangrante.

AIMS: To evaluate the efficacy of 3-day intravenous Helicobacter pylori eradication therapy in patients with bleeding peptic ulcer associated with H. pylori infection. MATERIAL AND METHOD: We studied 53 patients admitted to hospital with bleeding of the upper gastrointestinal tract due to peptic ulcer and positive urease test over a 12-month period. After endoscopic diagnosis, intravenous pantoprazole (40 mg/12 hours), metronidazole (500 mg/8 hours) and amoxicillin-clavulanic acid (1,000 mg/200 mg/8 hours) was administered for 72 hours. The efficacy of eradication therapy was evaluated by 13C-urea breath test at least 2 months after the end of treatment. RESULTS: Fifty-one patients were included. Of these, 40 had duodenal ulcer and 11 had gastric ulcer. H. pylori eradication was achieved in 87.5% of those with duodenal ulcers and in 63.6% of those with gastric ulcers (p = 0.066). No adverse reactions or episodes of bleeding recurrence were found and none of the patients withdrew from treatment. CONCLUSIONS: The ultra-short course eradication therapy used in this study is highly effective. Its efficacy is similar to that of oral treatment and it avoids certain problems such as adverse effects and adherence to treatment.

Terapia endoscópica con argón plasma de lesiones hemorrágicas de esófago / Endoscopic therapy with argon plasma of esofagic bleeding lesions

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