Premium
Multiple gastric red spots, capillary ectasia, hypergastrinemia and hypopepsinogenemia i in cirrhosis: A new syndrome?
Author(s) -
Samloff I. Michael
Publication year - 1988
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840080350
Subject(s) - medicine , cirrhosis , gastroenterology , gastric antral vascular ectasia , endoscopy , argon plasma coagulation
To characterize bleeding from gastric red spots in patients with cirrhosis, three groups of patients were studied: (a) 11 cirrhotic patients bleeding from gastric red spots, (b) 18 nonbleeding cirrhotic patients without gastric red spots, and (c) 13 non‐cirrhotic patients with endoscopic normal mucosa (controls). Histologic examination of antral biopsy specimens revealed a diffuse capillary ectasia without inflammation in 8 of the 11 cirrhotic patients with gastric lesions. Morphometric analysis disclosed a significantly greater mean mucosal capillary cross‐sectional area in cirrhotic patients with gastric lesions (mean ± SE, 1371 ± 320 μm 2 ) than in those without gastric lesions (541 ± 61 μm 2 ) (p < 0.005) or controls (353 ± 20 μm 2 ) (p < 0.001). Hypergastrinemia was detected in 8 of the 11 cirrhotic patients with lesions, in 2 of the 18 cirrhotic patients without gastric lesions, and in none of the controls (p < 0.001). Gastrin serum levels correlated significantly (r = 0.80) with mean mucosal capillary cross‐sectional area in patients with cirrhosis. Pepsinogen I serum levels below 20 ng/ml were observed in 7 of the 11 cirrhotic patients with lesions, in 1 of the 18 cirrhotic patients without lesions, and in none of the controls. These data indicate that bleeding from gastric red spots in patients with cirrhosis is a distinct entity characterized by vascular ectasia of the gastric mucosa. This condition seems to be associated with hypergastrinemia and low serum levels of pepsinogen I.