A case of isolated granulomatous gastritis that spontaneously resolved without Helicobacter pylori eradication

Isolated or idiopathic granulomatous gastritis (IGG) is a rare disease and its etiology remains unclear. Some recent papers have reported that IGG is caused by Helicobacter pylori. We present herein a case of IGG that resolved spontaneously without H. pylori eradication. A 54-year-old woman displayed rigidity and thickened folds in the gastric corpus on upper gastrointestinal series. Upper gastrointestinal endoscopy revealed erythematic mucosa and thickened folds. Biopsies of gastric mucosa taken via endoscopy showed noncaseating granulomas and H. pylori infection. The patient was diagnosed with IGG, as no causes of granuloma (e.g., Crohn's disease, sarcoidosis, foreign bodies), excluding H. pylori were identified. Since this patient did not have any symptoms, she was followed without medication, including for eradication of H. pylori. Rigidity and thickened folds normalized with 6 months. Although H. pylori is suspected as the cause of IGG, this case resolved without H. pylori eradication. We thus conclude that the cause of IGG is not H. pylori alone.