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Difference between revisions of "Reactive gastropathy"
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| Caption = Reactive gastropathy. [[H&E stain]]. | | Caption = Reactive gastropathy. [[H&E stain]]. | ||
| Synonyms = chemical gastritis, chemical gastropathy, NSAID gastropathy (if due to a NSAID) | |||
| Micro = foveolar hyperplasia - esp. tortuosity of glands in the "neck" region (S shaped glands), smooth muscle hyperplasia, scant inflammatory cells, +/-edema, +/-erosions | | Micro = foveolar hyperplasia - esp. tortuosity of glands in the "neck" region (S shaped glands), smooth muscle hyperplasia, scant inflammatory cells, +/-edema, +/-erosions | ||
| Subtypes = | | Subtypes = | ||
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'''Reactive gastropathy''', abbreviated '''RG''', a relatively common pathology of the [[stomach]]. It is also known as '''chemical gastropathy''',<ref name=pmid16939055>{{Cite journal | last1 = Genta | first1 = RM. | title = Differential diagnosis of reactive gastropathy. | journal = Semin Diagn Pathol | volume = 22 | issue = 4 | pages = 273-83 | month = Nov | year = 2005 | doi = | PMID = 16939055 }}</ref> and incorrectly referred to as '''chemical gastritis''' ([[Reactive gastropathy#Relation to gastritis|see below]]). | '''Reactive gastropathy''', abbreviated '''RG''', a relatively common pathology of the [[stomach]]. It is also known as '''chemical gastropathy''',<ref name=pmid16939055>{{Cite journal | last1 = Genta | first1 = RM. | title = Differential diagnosis of reactive gastropathy. | journal = Semin Diagn Pathol | volume = 22 | issue = 4 | pages = 273-83 | month = Nov | year = 2005 | doi = | PMID = 16939055 }}</ref> and incorrectly referred to as '''chemical gastritis''' ([[Reactive gastropathy#Relation to gastritis|see below]]). | ||
''NSAID gastropathy'' | ''NSAID gastropathy'' redirects to here. | ||
==General== | ==General== | ||
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**Iron (brown pigment on histology). | **Iron (brown pigment on histology). | ||
**[[NSAID]]s - synergistic effect with corticosteroids. | **[[NSAID]]s - synergistic effect with corticosteroids. | ||
**Steroids.<ref>URL: [http://www.cmej.org.za/index.php/cmej/article/view/2316/2190 http://www.cmej.org.za/index.php/cmej/article/view/2316/2190]. Accessed on: June 17, 2016.</ref> | |||
Notes: | Notes: | ||
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! Indication for Rx | ! Indication for Rx | ||
|- | |- | ||
| | | [[NSAID]]s | ||
| common cause | | common cause | ||
| pain, reduce cardiovascular risk | | pain, reduce cardiovascular risk | ||
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| Potassium (KCl) | | Potassium (KCl) | ||
| common cause | | common cause | ||
| | | [[congestive heart failure]]<ref name=pmid25960118>{{Cite journal | last1 = Weir | first1 = MR. | last2 = Espaillat | first2 = R. | title = Clinical perspectives on the rationale for potassium supplementation. | journal = Postgrad Med | volume = 127 | issue = 5 | pages = 539-48 | month = Jun | year = 2015 | doi = 10.1080/00325481.2015.1045814 | PMID = 25960118 }}</ref> | ||
|- | |- | ||
| Bisphophonates | | Bisphophonates | ||
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| Ferrous sulfate | | Ferrous sulfate | ||
| very common if symptomatic | | very common if symptomatic | ||
| iron deficiency anemia | | iron deficiency [[anemia]] | ||
|- | |- | ||
| Chloroquine | | Chloroquine | ||
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| Sodium polystyrene sulfonate (Kayexalate) | | Sodium polystyrene sulfonate (Kayexalate) | ||
| rare | | rare | ||
| renal failure | | [[renal failure]] | ||
|} | |} | ||
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==Sign out== | ==Sign out== | ||
<pre> | |||
Stomach, Antrum, Biopsy: | |||
- Antral-type gastric mucosa with reactive gastropathy. | |||
- NEGATIVE for Helicobacter-like organisms. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
===Block letters=== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
- ANTRAL-TYPE GASTRIC MUCOSA WITH REACTIVE GASTROPATHY, SEE COMMENT. | - ANTRAL-TYPE GASTRIC MUCOSA WITH REACTIVE GASTROPATHY, SEE COMMENT. | ||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | - NEGATIVE FOR INTESTINAL METAPLASIA. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
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</pre> | </pre> | ||
===RG and mild chronic gastritis=== | ====RG and mild chronic gastritis==== | ||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
- ANTRAL-TYPE GASTRIC MUCOSA WITH REACTIVE GASTROPATHY AND MILD CHRONIC | - ANTRAL-TYPE GASTRIC MUCOSA WITH REACTIVE GASTROPATHY AND MILD CHRONIC | ||
INACTIVE INFLAMMATION. | INACTIVE INFLAMMATION. | ||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | - NEGATIVE FOR INTESTINAL METAPLASIA. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||
===Not well-developed=== | ====Not well-developed==== | ||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
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- ANTRAL-TYPE GASTRIC MUCOSA WITH SMOOTH MUSCLE HYPERPLASIA, | - ANTRAL-TYPE GASTRIC MUCOSA WITH SMOOTH MUSCLE HYPERPLASIA, | ||
RARE GLAND TORTUOSITY AND NO SIGNFICANT INFLAMMATION, SEE COMMENT. | RARE GLAND TORTUOSITY AND NO SIGNFICANT INFLAMMATION, SEE COMMENT. | ||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | - NEGATIVE FOR INTESTINAL METAPLASIA. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
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</pre> | </pre> | ||
===Not well-developed with minimal inflammation=== | ====Not well-developed with minimal inflammation==== | ||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
- ANTRAL-TYPE GASTRIC MUCOSA WITH SMOOTH MUSCLE HYPERPLASIA, RARE GLAND TORTUOSITY | - ANTRAL-TYPE GASTRIC MUCOSA WITH SMOOTH MUSCLE HYPERPLASIA, RARE GLAND TORTUOSITY | ||
AND MINIMAL CHRONIC INACTIVE INFLAMMATION, SEE COMMENT. | AND MINIMAL CHRONIC INACTIVE INFLAMMATION, SEE COMMENT. | ||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | - NEGATIVE FOR INTESTINAL METAPLASIA. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
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</pre> | </pre> | ||
====Isolated smooth muscle prominence==== | =====Isolated smooth muscle prominence===== | ||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
- ANTRAL-TYPE GASTRIC MUCOSA WITH PROMINENT SMOOTH MUSCLE, OTHERWISE WITHIN NORMAL | - ANTRAL-TYPE GASTRIC MUCOSA WITH PROMINENT SMOOTH MUSCLE, OTHERWISE WITHIN NORMAL | ||
LIMITS. | LIMITS. | ||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | - NEGATIVE FOR INTESTINAL METAPLASIA. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||