The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case you would like to suggest for a future Case Challenge, please contact us.
A 13-year-old boy presents to the emergency department (ED) with a history of epigastric pain, vomiting, malaise, polyuria, and a 12-lb weight loss during the past 3 months. His parents have brought him to the emergency department today because his pain and vomiting are worsening. They report no history of hematuria, hematemesis, fever, or chills. They also do not note any other associated symptoms, prior surgeries, or medical conditions.
The patient was previously seen by his pediatrician and is undergoing a work-up. Upper gastroendoscopy performed at a nearby hospital 2 weeks ago had revealed chronic gastritis with erosive changes in the antral region. Triple treatment for Helicobacter pylori, however, did not lead to any improvement. Abdominal ultrasonography also performed at that time showed mild nephrocalcinosis.
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Cite this: Chronic Gastritis, a Lesion, and Weight Loss in a Teenager - Medscape - Feb 19, 2021.