Effects of Metiamide on Gastric Acid Hypersecretion, Steatorrhea and Bone-Marrow Function in a Patient with Systemic Mastocytosis

Abstract

Systemic mastocytosis is associated with excessive production of histamine, which would be expected to result in gastric acid hypersecretion.¹ However, acid hypersecretion is rarely observed in these patients.² The patient described below, who had systemic mastocytosis, steatorrhea and diarrhea, marked gastric acid hypersecretion with low duodenal pH and increased levels of blood and urine histamine, was treated with the H₂-receptor antagonist metiamide, which abolished the acid hypersecretion but failed to alter the steatorrhea or diarrhea. After seven weeks of metiamide therapy acute fatal agranulocytosis developed.Case ReportIn August, 1975, a 55-year-old man with systemic mastocytosis was evaluated . . .