Russell body gastritis in an Hp-negative patient.

To cite: Antunes AG, Cadillá J, Velasco F. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/bcr-2016216717 DESCRIPTION A 79-year-old woman with a longstanding gastrooesophageal reflux disease was admitted to the emergency room for haematemesis without other symptoms. The patient presented hemodynamic stability and had a haemoglobin of 12.6 g/L. In the upper endoscopy the cause of bleeding was an 8 mm mucosal break in the lower oesophagus classified as grade B in the Los Angeles classification for oesophagitis. Also, we identified in the incisura angularis, a whitish and nodular area of mucosa, with indefinite margins that were biopsied (figure 1). Given the clinical and laboratorial presentation, the patient was discharged with a proton pump inhibitor and was re-evaluated as an ambulatory outpatient, with a good clinical evolution. The histological examination (figure 2) revealed an infiltrate of plasma cells containing numerous eosinophilic inclusions at lamina propria and intestinal metaplasia (100% of the glands). Subsequent testing for Helicobacter pylori (Hp) infection was negative (stool antigen). We established the diagnosis of Russell body gastritis in an Hp-negative patient. Given the uncertain prognosis of this entity, the patient continues to have clinical, laboratorial and endoscopic follow-up at our centre.