Internal Medicine

0521779407-08 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:47

Gastropathy Geographic Tongue 621

Absolute: Pregnancy or lactating patients

Relative: None

follow-up

■H. pyloriinfection

➣Antibody titers decline slowly over many months

➣Need to wait 6–12 months to witness significant decline and/or

regression in lymphoma

➣Serology positive in up to 40% of successfully treated patients

➣Use urea breath test or upper endoscopy with biopsy to confirm

eradication

■Surveillance for gastric cancer in pernicious anemia

➣Endoscopy with biopsy initially

➣No endoscopic surveillance if no dysplasia detected

➣Endoscopy with biopsy every 2 years if dysplasia detected

■Surveillance for gastric cancer in postgastrectomy patients

➣Consider intial screening 10 years post-resection

➣Screening frequency not established

■Role of screening for early gastric cancer in Menetrier’s disease

➣True incidence of cancer unclear: ?related to postgastrectomy

state

➣Difficult to perform adequate tissue sampling of thickened folds

complications and prognosis

■Gastric cancer in minority of patients

➣Postgastrectomy

➣Pernicious anemia

➣?Menetrier’s disease

■Upper GI bleeding

Prognosis

■Lifespan normal in the absence of gastric cancer development

■Most patients with Menetrier’s disease, most do well after partial

gastric resection without recurrence

Geographic Tongue...................................

SOL SILVERMAN Jr, DDS

history & physical

■onset at any age

■no known etiology; rarely associated with medications or allergies