Helicobacter-induced Proliferative Syndrome: A Pan-Upper-Gastrointestinal Tract Proliferative Phenotype of Persistent Helicobacter pylori Infection

Helicobacter pylori typically produces endoscopic patterns described in the Kyoto classification. We report an unusual, diffuse proliferative phenotype spanning the esophagus, stomach, and duodenum that mimicked malignancy yet proved inflammatory on histology. A 32-year-old woman presented with 1 year of dysphagia with odynophagia, intermittent vomiting, retrosternal burning, and 10 kg weight loss. Endoscopy showed nodular, fibrotic, synechiae-forming mucosa throughout the esophagus and a mass-like, erythematous, nodular gastric surface with duodenal inflammation. Multiple biopsies revealed chronic active esophagitis, chronic active gastritis with foveolar hyperplasia and abundant H. pylori , and nonspecific duodenitis; no dysplasia or carcinoma was seen. We propose the descriptive entity “Helicobacter-induced Proliferative Syndrome” (HIPS) for this striking, tumor-like phenotype of persistent H. pylori infection. HIPS emphasizes the need for a generous multi-site biopsy to exclude malignancy and for individualized, resistance-informed eradication with objective test-of-cure and endoscopic follow-up in refractory cases.