Severe erosive hemorrhagic gastritis in a pediatric patient

ARPC1B Mutation Manifesting as Recurrent Hematemesis With Metaplasia

ARPC1B is important in the maintenance and assembly of the ARP2/3 complex. Loss of this complex due to ARPC1B mutation results in impairment of actin polymerization and subsequent defects in chemotaxis, cell migration, and DNA repair. Individuals with this rare mutation present in infancy and have abnormal innate and adaptive immune responses. They develop immune-mediated inflammatory disease with associated platelet defects, eosinophilia, rashes, and bowel disease. Recurrent gastrointestinal hemorrhage has been described in known cases. Here, we report a case with endoscopic and histologic findings in a patient with this rare mutation.

Clinical efficacy of lansoprazole enteric-coated tablets combined with flupentixol-melitracen in patients with erosive gastritis and anxiety

AIM: To evaluate the clinical efficacy of lansoprazole enteric-coated tablets combined with flupentixol-melitracen in the treatment of patients with erosive gastritis and anxiety.

METHODS: One hundred and eight patients with erosive gastritis treated at the 154^th Center Hospital of Chinese PLA from January 2012 to January 2014 were randomly divided into either an observation group or a control group, with 54 patients in each group. The control group was given lansoprazole enteric-coated tablets alone, and the observation group was treated with lansoprazole enteric-coated tablets + flupentixol-melitracen. Cinical symptoms and mucosal erosion were compared between the two groups of patients before and after treatment. Gastric mucosa malondialdehyde (MDA) and prostration E₂ (PGE₂) contents, anxiety and depression status were also assessed.

RESULTS: After treatment, the scores of abdominal pain, bloating, acid reflux, belching, and mucosal erosions were significantly lower in the observation group than in the control group (0.6 ± 0.1 vs 1.2 ± 0.3, 0.4 ± 0.1 vs 1.1 ± 0.2, 0.3 ± 0.1 vs 0.9 ± 0.2, 0.6 ± 0.2 vs 0.8 ± 0.2, 0.6 ± 0.2 vs 1.4 ± 0.3, P < 0.05). PGE₂ and MDA contents in the gastric mucosa in the treatment group (5.4 ng/mg ± 0.9 ng/mg, 0.8 ng/mg ± 0.1 ng/mg) were significantly different from those in the control group (3.2 ng/mg ± 0.5 ng/mg, 2.1 ng/mg ± 0.9 ng/mg) (P < 0.05). After treatment, SAS and SDS scores were significantly lower in the observation group than in the control group (53.7 ± 9.1 vs 58.9 ± 11.0, 45.4 ± 6.8 vs 54.6 ± 7.6, P < 0.05).

CONCLUSION: Lansoprazole enteric-coated tablets combined with flupentixol-melitracen has better clinical efficacy than lansoprazole enteric-coated tablets alone in patients with erosive gastritis and anxiety in terms of the improvement of clinical symptoms and mucosal erosion and the relief of negative emotions.