The role of high sensitive C-reactive protein and histopathological evaluation in chronic gastritis patients with or without Helicobacter pylori infection

Abstract Purpose: To evaluate serum levels of high-sensitivity C-reactive protein (hs-CRP) in chronic gastritis patients to predict Helicobacter pylori (HP) infection, inflammatory activity, and precancerous lesions. Methods: A total of 811 patients with upper gastrointestinal symptoms and histopathological diagnosis of chronic gastritis were enrolled in the study. On endoscopy, five gastric biopsies were taken according to Modified Sydney protocol, which were stained with hematoxylin & eosin and Giemsa Results: HP infection was found in 28.6% of patients, being significantly more common in specimens with acute and chronic inflammatory activity. Mucosal atrophy, intestinal metaplasia, and dysplasia were found in 20.2%, 18.8% and 2.7% of biopsy specimens. Mean hs-CRP was 1.9±1.6 mg/dl for males and 2.2±1.9 mg/dl for females. hs-CRP average were significantly higher in patients with severe acute inflammation (p:0.049), in patients with severe chronic inflammation (p:0.015) and in those with HP (p: 0.001) . The severity of HP infection increased significantly with the increased degree of acute inflammation, chronic inflammation and hs-CRP level (p=0.001 for both). Conclusion: Serum hs-CRP level increases in patients with chronic gastritis, it could be an indicator of severity of acute or chronic mucosal inflammation, and presence of HP infection. Therefore, hs-CRP may aid the diagnosis of chronic gastritis, but it is not associated with pre-cancerous lesions.

Bleeding due to slippage of elastic band during variceal ligation: successful use of Ankaferd blood stopper.

Ankaferd blood stopper (ABS) is a hemostatic agent that induces clot formation by a special protein network which mainly causes powerful erythrocyte aggregation. The use of topical ABS as a hemostatic agent has been approved in Turkey for the management of dermal, external post-surgical and postdental surgery bleeding. ABS has been successfully used in Dieulafoy lesion and bleeding from gastrointestinal neoplasms. We present a patient with alcoholic cirrhosis who developed severe bleeding during an elective endoscopic variceal ligation (EVL) session due to immediate band slippage, in whom endoscopic topical application of ABS was associated with cessation of bleeding. The major advantages of ABS appear to be ease of use and lack of side effect.