Difference between revisions of "Reactive gastropathy"

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| Width      =
| Width      =
| 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'' redirect to here.
''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
|-
|-
| NSAIDs
| [[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
| renal failure
| [[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 patients
| [[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 HELICOBACTER-LIKE ORGANISMS.
- 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 HELICOBACTER-LIKE ORGANISMS.
- 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 HELICOBACTER-LIKE ORGANISMS.
- 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 HELICOBACTER-LIKE ORGANISMS.
- 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 HELICOBACTER-LIKE ORGANISMS.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
</pre>
</pre>
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