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Transient hypergastrinemia of 2 years' duration in a young pediatric patient
Insights
A pediatric case of persistent diarrhea and growth failure resolved spontaneously. This rare condition, initially marked by hypergastrinemia and G cell hyperplasia, highlights the potential for self-resolution in certain gastrointestinal disorders.
Area of Science:
- Pediatric Gastroenterology
- Endocrinology
- Cell Biology
Background:
- A 24-month-old female presented with persistent watery diarrhea, growth failure, and abdominal pain starting at 3 months of age.
- Initial investigations revealed hypergastrinemia, hypochlorhydria, and fundic gastritis, suggesting a complex gastrointestinal issue.
Observation:
- A secretin stimulation test yielded normal results, but a protein meal challenge demonstrated an abnormal serum gastrin response.
- Antral biopsies confirmed G cell hyperplasia, a key finding in the observed hypergastrinemia.
Findings:
- Despite unsuccessful treatment with antacids and anticholinergic agents, the child experienced spontaneous clinical and laboratory remission at 29 months of age.
- Repeated diagnostic tests, including gastrin stimulation, gastric acid secretion analysis, and antral biopsies, all normalized post-recovery.
Implications:
- This case suggests that some instances of pediatric hypergastrinemia with G cell hyperplasia may undergo spontaneous resolution.
- The findings underscore the importance of long-term follow-up in pediatric gastrointestinal disorders, even after initial lack of treatment response.
Abstract:
A 24-month-old female child experienced watery diarrhea, growth failure, and abdominal pain from age 3 months. Hypergastrinemia, hypochlorhydria, and fundic gastritis were documented. A secretin stimulation test was normal but protein meal stimulation revealed an abnormal serum gastrin response. Antral biopsies revealed G cell hyperplasia. Chronic treatment with antacids and an anticholinergic agent was unsuccessful. Spontaneous recovery occurred at age 29 months. Gastrin stimulation tests, gastric acid secretory tests, antral mucosal biopsies, and multiple basal serum gastrin levels were repeated. All were normal. Follow-up of greater than 3 years has documented a completely normal clinical and laboratory course.