pantoprazole / Generic mfg. - LARVOL DELTA

Pantoprazole as a potential repurposed drug targeting the adenosinergic system in esophageal cancer. (PubMed, Med Chem Res) - "Additionally, pantoprazole modulated CD73 expression and reduced cell adhesion and MMP‑2 expression. These findings indicate that pantoprazole exerts antitumor effects by modulating the CD73-adenosine-P1 receptor axis, supporting its potential repurposing as an adjunctive strategy for the treatment of esophageal adenocarcinoma."

Journal • Esophageal Adenocarcinoma • Esophageal Cancer • Immune Modulation • Immunology • Oncology • Solid Tumor • Squamous Cell Carcinoma • CD73 • MMP2 • NT5E

Beneath the Ulcer: Uncovering Gastrointestinal AL Amyloidosis (ACG 2026) - "Case Description/ 50 year-old woman with kappa light-chain multiple myeloma and heart failure with reduced ejection fraction presented with epigastric and substernal pain.No NSAID use expect aspirin 81mg was reported. Multiple myeloma was well controlled on daratumumab and pomalidomide with stable serial bone marrow biopsies...She was started on pantoprazole 40 mg twice daily...(b) Surveillance endoscopy demonstrating a single large deep ulcer with a flat pigmented spot (Forrest IIC), with no interval healing despite prolonged high-dose proton pump inhibitor therapy. (c) Subsequent endoscopy with endoscopic ultrasound (EUS) showing interval improvement of the previously non-healing ulcer, now appearing as a 10 mm linear erosion."

Amyloidosis • Cardiovascular • Congestive Heart Failure • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Hematological Malignancies • Multiple Myeloma • Peptic Ulcer

An Unexpected Pathology, Incidental Detection of Gastric Signet Ring Cell Adenocarcinoma on Routine Gastric Biopsies (ACG 2026) - "Patient was recommended on tobacco cessation, and was started on Protonix 40 mg daily...Histological exam can uncover serious pathology despite unremarkable appearance as this lesion was not noted on the initial EGD and biopsies were random and not targeted. Figure: Gastric antrum on initial EGD Figure: 6 mm lesion in the lesser curvature of the gastric antrum at the 11 o'clock position under NBI"

Biopsy • Cardiovascular • Celiac Disease • Chronic Obstructive Pulmonary Disease • CNS Disorders • Colonic Polyps • Depression • Dyslipidemia • Gastroenterology • Gastroesophageal Reflux Disease • Immunology • Oncology • Respiratory Diseases • Tobacco Addiction • Tobacco Cessation

Helicobacter heilmannii Gastritis Identified on Random Gastric Biopsy in a Patient With Nondysplastic Barrett's Esophagus (ACG 2026) - "He was treated with 14 days of bismuth-based quadruple therapy using pantoprazole, metronidazole, tetracycline, and bismuth subsalicylate. Random gastric biopsies should be considered when symptoms persist, even when the gastric mucosa appears normal. Figure: Endoscopic images showing an irregular Z-line with otherwise grossly normal gastric and duodenal mucosa."

Biopsy • Clinical • Barrett Esophagus • Celiac Disease • Extranodal Marginal Zone Lymphoma • Gastric Cancer • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Immunology • Infectious Disease • Lymphoma • Marginal Zone Lymphoma • Peptic Ulcer • Solid Tumor

Multiple Gastroduodenal Ulcers of Unknown Etiology in a Patient With Newly Diagnosed Myasthenia Gravis: A Diagnostic Challenge With Concern for Zollinger-Ellison Syndrome (ACG 2026) - "She was discharged on pantoprazole with planned repeat endoscopy in two months...Figure: (A) Coronal computed tomography angiogram (CTA) head/neck with contrast demonstrating 3.5 cm multinodular goiter in left thyroid lobe. (B) Coronal CT thorax with contrast demonstrating 2.0 cm left adrenal nodule (see ellipses)."

Clinical • Atherosclerosis • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Diabetes • Endocrine Disorders • Gastroenterology • Gastrointestinal Disorder • Hypertension • Infectious Disease • Metabolic Disorders • Myasthenia Gravis • Nephrology • Peptic Ulcer • Renal Disease • Solid Tumor • GAST

Iron Pill Gastritis With Concomitant Peptic Esophageal Stricture in a Patient With Iron Deficiency Anemia (ACG 2026) - "Pantoprazole 40 mg twice daily was continued, with repeat EGD planned to confirm ulcer healing...Endoscopic image of the gastric body demonstrating a second area of mucosal ulceration and erythema. The presence of multiple concurrent gastric ulcers in this distribution is consistent with iron-induced mucosal injury from oral ferrous sulfate supplementation."

Clinical • Anemia • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Peptic Ulcer

A Rare Cause of Gastric Outlet Obstruction: Duodenal Adenosquamous Carcinoma (ACG 2026) - "She had been taking Famotidine, Pantoprazole, and Sucralfate with minimal improvement. Figure: Heterogenous enhancing tumor in the first portion of the duodenum leading to gastric outlet obstruction. Figure: Endoscopic view of large extrinsic bulge into pre-pyloric region"

Colorectal Cancer • Dyspepsia • Endocrine Disorders • Gastric Cancer • Gastroenterology • Gastrointestinal Disorder • Hepatology • Hypertension • Melanoma • Metabolic Disorders • Oncology • Small Intestinal Carcinoma • Solid Tumor

DOAC Does Damage: Biopsy-Confirmed Cholestatic DILI From Apixaban (ACG 2026) - "Case Description/ A 79-year-old man with Barrettâs esophagus on pantoprazole, atrial fibrillation, prior bladder and prostate cancer, CKD3, and type 2 diabetes presented with weakness, dyspnea, and epigastric pain. However, the absence of obstruction and characteristic histopathology favored DILI as the primary driver. This case underscores the need to consider rare adverse drug reactions even with commonly used agents."

Biopsy • Atrial Fibrillation • Barrett Esophagus • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Genito-urinary Cancer • Hepatology • Immunology • Liver Failure • Metabolic Disorders • Prostate Cancer • Pulmonary Disease • Solid Tumor • Type 2 Diabetes Mellitus

Beyond the Obstruction: Cytomegalovirus Duodenitis as a Herold for Diffuse Large B-Cell Lymphoma (ACG 2026) - "His symptoms improved with pantoprazole...He was treated with 21 days of valganciclovir, resulting in partial improvement of symptoms and ability to tolerate a regular diet...Figure: Figure 2. Coronal CT image showing a stricture near the duodenojejunal junction with upstream dilatation of the duodenum and stomach concerning for small bowel obstruction."

B Cell Lymphoma • Cytomegalovirus Infection • Diffuse Large B Cell Lymphoma • Epstein-Barr Virus Infections • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Hepatitis B • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Lymphoma • Non-Hodgkin’s Lymphoma

Isolated Gastric Variceal Hemorrhage From Sinistral Portal Hypertension in JAK2 V617F-Positive Myeloproliferative Neoplasm (ACG 2026) - "Case Description/ A 48-year-old male with JAK2 V617F-positive MPN and chronic portal and splenic vein thrombosis, noncompliant with hydroxyurea and warfarin therapy, presented with 1 episode of hematemesis...He was resuscitated with vasopressors, octreotide, and pantoprazole infusion, and treated with rasburicase for TLS...He was ultimately transitioned to ruxolitinib as outpatient therapy, with normalization of counts and resolution of bleeding at follow-up...Figure: Figure 2. Esophagogastroduodenoscopy showing extensive isolated gastric varices (IGV1 and IGV2) and an actively bleeding, ulcerated varix (image 14), which was clipped endoscopically."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Hypertension • Myeloproliferative Neoplasm • Portal Hypertension • Thrombocytosis • Thrombosis • Varicose Veins • JAK2

Upper Gastrointestinal Hemorrhage From Duodenal Varices Presenting as out of Hospital Cardiac Arrest (ACG 2026) - "The patient was started on IV pantoprazole, octreotide, and cefepime. CT angiography findings of paraduodenal varices with active extravasation into the duodenum Figure: Image 2. Coil and liquid embolization of the duodenal varices using balloon-occluded antegrade transvenous obliteration (BATO)"

Clinical • Addiction (Opioid and Alcohol) • Cardiovascular • Fibrosis • Hematological Disorders • Hepatology • Hypertension • Immunology • Portal Hypertension

An Unusual Cause of Upper Gastrointestinal Bleeding: Primary Gastric Diffuse Large B-Cell Lymphoma (ACG 2026) - "Patient received IV fluids, 1 unit of pRBCs, and pantoprazole infusion...Notably, this patient's chronic NSAID use, raises concern for a contributory role as some observational studies have identified associations between long-term use of NSAID use and NHL. Figure: Gastric biopsy showing DLBCL Figure: Gastric ulcer"

B Cell Lymphoma • Diabetes • Diffuse Large B Cell Lymphoma • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Hypertension • Lymphoma • Metabolic Disorders • Non-Hodgkin’s Lymphoma • Peptic Ulcer • Pulmonary Disease • Type 2 Diabetes Mellitus

Gastrogastric Fistula: A Delayed Cause of Acute GI Bleeding Post- Roux-en-Y Gastric Bypass (ACG 2026) - "The patient was treated with high-dose IV pantoprazole...In this patient, the event was likely precipitated by prior tobacco use and apixaban...Early recognition can prevent recurrent ulceration and avoid the need for high-risk surgical revision. Figure: Fig.1; A: Gastric Cardia- arrows point to fistula between the gastric pouch and the excluded stomach B: Gastric Antrum C: Gastric Cardia- arrow points to gastrojejunal anastomosis D: Gastric Cardia- ulcer with clot in the gastric pouch near the gastrojejunal anastomosis"

Bariatric surgery • Cardiovascular • Gastrointestinal Disorder • Hematological Disorders • Peptic Ulcer • Renal Calculi • Tobacco Cessation

Rebleeding Ulcer 23 Months After Over-The-Scope Clip Placement: A Late Complication (ACG 2026) - "The patient was treated with a pantoprazole drip and was monitored...Figure: Prior Ovesco clip in the anterior duodenal bulb with surrounding stigmata of recent bleeding. Figure: Clot visualized in the duodenal bulb"

Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Peptic Ulcer

When Ostomy Bleeding Isnât Surgical: Occult Helicobacter PyloriâAssociated Duodenal Ulcer Presenting After Colectomy (ACG 2026) - "Emergent EGD revealed a bleeding duodenal ulcer with a visible vessel, treated with epinephrine injection, gold probe thermal therapy, and endoclips (Figure 1, 2)...He improved on intravenous pantoprazole and antibiotics without recurrent bleeding...Figure: Figure 1: Endoscopic view of a bleeding duodenal ulcer. Figure: Figure 2: Post-intervention endoscopic image demonstrating successful hemostasis following clip placement."

Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hypotension • Infectious Disease • Peptic Ulcer • Stress Ulcer

When Collateral Circulation Fails: Acute Ischemic Emphysematous Gastritis Leading to Upper Gastrointestinal Bleeding (ACG 2026) - "He was treated with blood transfusions, intravenous fluids, broad-spectrum antibiotics, antifungals, and high-dose pantoprazole...Figure: Endoscopic view showing extensive necrosis involving the gastric body and fundus, with ulceration, adherent blood clots, and exudates affecting >50% of the luminal circumference. Figure: Coronal non-contrast CT image of the abdomen and pelvis demonstrating extensive portal venous gas and intramural gastric gas, consistent with emphysematous gastritis."

Atherosclerosis • Cardiovascular • Diabetes • Gastroenterology • Gastrointestinal Disorder • Genito-urinary Cancer • Hypotension • Metabolic Disorders • Renal Cell Carcinoma • Respiratory Diseases • Solid Tumor

When Hiccups Persist: An Atypical Presentation of Esophageal Candidiasis in an Immunocompetent Patient (ACG 2026) - "Outpatient treatment with baclofen, gabapentin, and pantoprazole failed to improve his symptoms, prompting hospital admission for further evaluation...He was treated with intravenous chlorpromazine, gabapentin, metoclopramide, empiric antibiotics for suspected pneumonia, and pantoprazole for possible reflux esophagitis, however, hiccups persisted...Figure: EGD demonstrating diffuse white plaques consistent with candidal esophagitis in the middle third (left) and lower third (right) of the esophagus. Figure: Hematoxylin and eosin staining demonstrating active esophagitis with acute inflammation (left) and fungal organisms morphologically consistent with Candida species, including budding yeast and pseudohyphae (right)."

Clinical • Candidiasis • Gastrointestinal Disorder • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Pneumonia • Respiratory Diseases

Esophageal Blebs as a Clue to Occult Descending Aortic Dissection (ACG 2026) - "He received pantoprazole, octreotide, ceftriaxone, and fluids, then was transferred for EGD...Blood cultures grew MSSA, suspected from leg wounds, and cefazolin was started...Although imaging showed no compression, coexistence of esophageal submucosal discoloration and thoracic aortic intramural pathology suggests an association. Figure: Localized moderate mucosal changes characterized by congestion, erythema, erosion and altered texture were found in the lower third of the esophagus Figure: Esophageal blebbing seen on EGD"

Addiction (Opioid and Alcohol) • Cardiovascular • CNS Disorders • Epilepsy • Fibrosis • Gastrointestinal Disorder • Hematological Disorders • Hepatology • Immunology • Infectious Disease • Inflammation • Nicotine Addiction • Pneumonia • Portal Hypertension • Respiratory Diseases • Thrombosis

Acute Esophageal Obstruction From a Glucomannan-Containing Weight-Loss Supplement (ACG 2026) - "During the current presentation, intravenous glucagon, ondansetron, acetaminophen, pantoprazole, and fluids were administered without improvement. Guar gum diet pills were subsequently removed from the market. Unfortunately, glucomannan-containing supplements such as Lipozene remain freely available without clear-cut instructions to drink enough water and without clear warnings on the labels particularly for patients with pre-existing esophageal diseases."

Cardiovascular • Dyslipidemia • Gastrointestinal Disorder • Hypertension • Nicotine Addiction • Tobacco Addiction

An Uncommon Cause of Upper Gastrointestinal Hemorrhage: Acute Esophageal Necrosis With Candida glabrata Fungemia (ACG 2026) - "Micafungin was initiated and transitioned to fluconazole based on susceptibility testing...He was discharged on fluconazole and pantoprazole for eight weeks, with no recurrent bleeding at two-week follow-up...Endoscopy was essential not only for diagnosis but for identifying necrosis predisposing to systemic infection. Physicians should suspect AEN in patients with DKA and upper GI bleeding, recognize necrotic mucosa as a potential infectious source, and monitor vigilantly for septic complications."

Acute Kidney Injury • Addiction (Opioid and Alcohol) • Diabetes • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Hematological Disorders • Hypotension • Infectious Disease • Metabolic Disorders • Nephrology • Ocular Infections • Ocular Inflammation • Ophthalmology • Renal Disease • Thrombocytopenia

A Rare Variant: An Endoscopic Finding of Inverted Squamous Cell Papilloma of the Gastroesophageal Junction (ACG 2026) - "Patient started on pantoprazole 20 mg a day, with improvement in reflux symptoms, with a plan for follow-up endoscopy in 6 months...Additional case reports and long-term follow-up studies are needed to help identify the malignant potential of esophageal ISCP and inform evidence-based surveillance recommendations. AI tool used for formatting of discussion Figure: Esophageal nodule at GE junction with keratinized spots and mild esophagitis Figure: Endophytic proliferation of squamous epithelium with tongues extending into the lamina propria"

Barrett Esophagus • Gastroenterology • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Human Papillomavirus Infection • Infectious Disease • Otorhinolaryngology

Proton Pump Inhibitor-Associated Rhabdomyolysis: A Systematic Review of Pharmacovigilance Disproportionality Studies (ACG 2026) - "Pantoprazole was the weakest and nonsignificant in the Italian data (ROR 1.15; 95% CI 0.90-1.49). From 251 records, 196 were screened after duplicate removal. A disproportionate signal linking PPIs to rhabdomyolysis was identified across all three databases, with the magnitude varying by agent. In FAERS, all five PPIs showed significant RORs, with lansoprazole the strongest (ROR 12.67; 95% CI 11.66-13.77); esomeprazole, omeprazole, and rabeprazole were consistently significant across FAERS and JADER."

Adverse events • Review • Musculoskeletal Pain • ROR1

Microscopic Colitis Unmasked: A Treatable Mimic of Gastrointestinal Amyloidosis in Wild-Type ATTR Cardiac Amyloidosis (ACG 2026) - "We present a case of an ATTRwt patient with significant diarrhea found to have biopsy-proven lymphocytic colitis and negative Congo red staining.â¯â¯ Case Description/ An 84-year-old male with ATTRwt cardiac amyloidosis, diagnosed one year prior with a positive technetium pyrophosphate scan and negative genetic testing, now on Acoramidis, presented with chronic non-bloody diarrhea for 2 years...His medications included aspirin, metoprolol, atorvastatin, and pantoprazole...The robust response to budesonide supports microscopic colitis as the most likely etiology. As ATTRwt diagnosis becomes more frequent with increased disease awareness, recognizing co-occurring GI conditions will be essential to avoid misattribution and ensure targeted treatment.⯠Figure: Clinical Timeline: ATTRwt Cardiac Amyloidosis with Co-occurring Lymphocytic Colitis"

Amyloidosis • Cardiac Amyloidosis • Cardiomyopathy • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Immunology

Isolated Collagenous Gastritis With Biopsy-Confirmed Histologic Resolution Following Etodolac Cessation in an Adult With Psoriatic Arthritis and Atopic Diathesis (ACG 2026) - "Medication included chronic daily etodolac, adalimumab, and valsartan...An empiric 8-week course of pantoprazole 40mg twice daily failed to improve symptoms...Without an identifiable etiology, etodolac was discontinued, and therapy was transitioned to omeprazole 40mg twice daily...(A) Initial evaluation demonstrating diffuse moderate inflammation with erythema, edema, erosions, and friability of the gastric body. (B) Follow-up endoscopy after etodolac cessation showed a more uniform mucosal surface with reduced erythema and fewer erosive changes."

Biopsy • Clinical • Allergic Rhinitis • Atopic Dermatitis • Celiac Disease • Dermatitis • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammation • Inflammatory Arthritis • Psoriatic Arthritis • Rheumatology • Seronegative Spondyloarthropathies

A New Diagnosis of AL Kappa Amyloidosis in the Setting of Refractory Peptic Ulcer âThe Ulcer That Wouldnât Heal: Unmasking AL Kappa Amyloidosisâ (ACG 2026) - "She was started on 40mg pantoprazole daily with mild symptom improvement...Isolated gastric amyloidosis is rare but should remain on the differential in patients without clear explanation for their symptoms and persistent gastric inflammation. Figure: Moderate heme in stomach with persistent erosion in the gastric antrum about 3 mm in size with no raised borders or mucosal defect"

Amyloidosis • Cardiovascular • CNS Disorders • Gastroenterology • Gastrointestinal Disorder • Inflammation • Multiple Sclerosis • Peptic Ulcer