Phlegmonous gastritis developed during chemotherapy for acute lymphocytic leukemia: A case report

Table 1 Transition of the data on day 11 to day 17

	(Normal range)	Day 11	Day 13	Day 15	Day 17
WBC (/μL)	(4000-8000)	100	500	45000	66000
Myelocyte	-		1	10	7
Metamyelocyte	-		1	4	14
Stab leukocytes (%)	0-6		3	3	4
Segmented leukocytes (%)	45-68	98	49	59	67
Lymphocytes (%)	20-45	1	16	5	1
Monocytes (%)	2-8	1	29	19	7
Eosinophils (%)	0-6		1
RBC (× 104/μL)	380-500	448	260	303	318
Hb (g/dL)	12.0-16.0	11.5	6.7	8.1	8.6
Platelet (× 104/μL)	12.0-40.0	3.2	3.3	8.1	17.9
CRP (mg/dL)	< 0.30	29.71	46.82	16.93	8.01
TP (g/dL)	6.7-8.3	5.1	4.2	4.1	4.3
Alb (g/dL)	3.8-5.3	2.9	1.9	1.9	2.2
AST (U/L)	8-38	41	21	67	48
ALT (U/L)	4-44	34	26	79	79
LDH (U/L)	120-245	142	299	1175	973
ALP (U/L)	105-330	215	232	388	545
γ-GTP (U/L)	< 30	15	13	43	72
T-Bil (mg/dL)	0.2-1.2	0.5	0.5	0.4	0.4
BUN (mg/dL)	8.0-20.0	39.4	21.2	17.8	14.7
Cr (mg/dL)	0.50-0.86	1.97	1.11	0.77	0.85
e-GFR (mL/min/1.73 m2)	> 90	20.2	38.2	56.4	50.6

WBC: White blood cells; RBC: Red blood cells; Hb: Hemoglobin; CRP: C-reactive protein; TP: Total protein; Alb: Albumin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; LDH: Lactate dehydrogenase; ALP: Alkaline phosphatase; γ-GTP: γ-glutamyl transpeptidase; T-Bil: Total bilirubin; BUN: Blood urea nitrogen; Cr: Creatinine; e-GFR: Estimated glomerular filtration rate.

Table 2 Clinical features of phlegmonous gastritis after chemotherapy for hematological malignancy

No.	Ref.	Age	Sex	Hematological malignancy	WBC/neutrophils	Pathogen(s)	Histopathological examination	Gastric acid secretion inhibitor	Outcome
1	Takeuchi et al[10]	63	M	ATLL	300/unknown	Gram-positive cocci and Gram-negative bacilli1	Not executed	H2-RA	Death
2	Matsumoto et al[11]	74	M	MF and MM	800/300	Bacillus thuringiensis	Not executed	Unknown	Death
3	Iqbal et al[12]	59	F	AML (2nd relapse)	< 100/0	Citrobacter freundii/Enterococcus faecalis/Bacillus cereus	Not executed	Unknown	Recovered
4	Inagawa et al[13]	34	F	APL with MF	320/20	Enterobacter cloacae/Enterococcus species/MRS	Not executed	PPI	Death
5	Shi et al[14]	33	M	MPAL	70/unknown	Stenotrophomonas maltophilia	Not executed	PPI	Recovered
6	Saito et al[9]	55	F	ALL	100/4	Bacillus cereus	Executed	PPI	Recovered
7 (this case)		70	F	ALL	100/98	Bacillus cereus	Executed	P-CAB	Recovered

¹Colonies were confirmed, but bacterial species could not be identified. ATLL: Adult T-cell leukemia/lymphoma; MF: Myelofibrosis; MM: Multiple myeloma; AML: Acute myeloid leukemia; APL: Acute promyelocytic leukemia; MPAL: Mixed-phenotype acute leukemia; ALL: Acute lymphocytic leukemia; WBC: White blood cells; MRS: Methicillin-resistant Staphylococcus; H₂-RA: Histamine H₂-receptor antagonist, PPI: Proton pump inhibitor; P-CAB: Potassium-competitive acid blocker; M: Male; F: Female.