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case_images: (a-d) Endoscopic images (a, b) before the initiation of Vonoprazan therapy. (c, d) after 19 months of Vonoprazan use, linear and spotty redness and multiple small hyperplastic polyps in the body became prominent in addition to previously observed fundic gland polyps.
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case_images: His symptoms resolved soon after starting Vonoprazan; however, red hyperplastic polyps became prominent in addition to previously observed fundic gland polyps (Figure 1).
case_images: (a-d) Endoscopic images (a, b) after 59 months of Vonoprazan use, showing a hemorrhagic polyp (blue arrow) before resection. (c, d) After 69 months of Vonoprazan use, revealing the growth of new polyps was growing following the resection (yellow circle).
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case_images: Despite the intervention, other hyperplastic polyps continued to grow (Figure 2).
case_images: (a-c) Endoscopic images after switching to H2 blockers, showing a significant deduction of polyps in the stomach. (d) Endoscopic images revealing ulcers in the duodenum. This image shows an ulcer located in the superior duodenal angle.
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case_images: However, multiple erosions, including 10 mm ulcers, were observed from the superior duodenal angle to the descending part of the duodenum (Figure 3).
case_images: (a-c) Histological images. (a) Hematoxylin and eosin staining showing parietal cell hyperplasia in the gastric body, (b) Anti-synaptophysin staining showing increased enterochromaffin-like cells in the gastric body, and (c) Anti-gastrin staining showing G cell hyperplasia in the antrum. Scale bars; 250 microm.
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case_images: Histological analysis of gastric tissue showed parietal cell hyperplasia in the corpus of the upper greater curvature and G-cell hyperplasia in the antrum of the upper greater curvature (Figure 4).