Isolated granulomatous gastritis successfully treated by Helicobacter pylori eradication: a possible association between granulomatous gastritis and Helicobacter pylori

We report two cases of granulomatous gastritis that resolved completely with Helicobacter pylori eradication. Two Japanese women, one 61 years old and one 58 years old, presented to our hospital with epigastralgia. Endoscopy revealed multiple shallow ulcerative lesions in the gastric corpus of both patients. Biopsy specimens demonstrated acute and chronic inflammation with multiple small, noncaseating granulomas at the level of the foveolar isthmi—the junction between the pits and the glands. Both specimens were positive for Helicobacter pylori. No other causes of organic granulomatous disease could be found. Both patients were diagnosed as having isolated granulomatous gastritis and were given triple therapy for Helicobacter pylori eradication, with their fully informed consent. The granulomatous gastritis resolved after successful Helicobacter pylori eradication therapy. This report describes a possible association between isolated granulomatous gastritis and Helicobacter pylori infection. To our knowledge, this is the first report describing isolated granulomatous gastritis successfully treated by triple therapy (Helicobacter pylori eradication therapy).