Gastric Metaplasia and Small Bowel Ulcerogenesis in a Case of Ulcerative Jejunitis Not Related to Celiac Disease

Abstract

The possible relationship between gastric metaplasia and ulcerative lesions in an anusual case of ulcerative jejunitis not related to celiac disease and with extensive gastric meta-plasia is discussed. Previous studies have described gastric metaplasia in duodenal ulcers on the basis of endoscopic data, and some authors maintain that acid secretion in meta-plastic mucosa could represent a pathogenetic factor of ulcerogenesis, with a self-amplifying mechanism. In the absence of functional evidence, we could provide data, in a case of ulcerative jejunitis, about morphologic signs of acid secretion in gastric metaplastic epithelium using an antibody against HMFG-1, a good marker of acid-secreting fundic cells. Metaplastic areas demonstrated a focal positivity for HMFG-1, and these finding are suggestive of local acid secretion.