Gastric xanthelasma is a rarely encountered finding in upper gastrointestinal (GI) endoscopy. It is characterised by yellowish-white plaque in the stomach especially in the antrum or the pyloric region. Histologically it consists of foamy macrophages in the lamina propria. It is a benign condition but its appearance mimics malignancy and it is found to be associated with various conditions, some of which are considered premalignant so, histological confirmation is necessary. We present a case of a 44-year-old man who presented to the medicine outpatient department for intermittent pain in epigastrium for the last 2 years. His physical examination was normal. His haematological and biochemical investigations were also normal. His upper GI endoscopy revealed yellowish-white plaque in fundus of the stomach, which was diagnosed as gastric xanthelasma by histological examination with associated chronic gastritis.
Domperidone is a commonly prescribed antiemetic drug but its side effects are rarely seen. Extrapyramidal side effects are a very rare complication of the drug occurring in 1/10,000 population. They usually occur in infants and very young children due to a poorly developed blood-brain barrier. We report a case of acute dystonia in a 13-year-old boy induced by domperidone. The boy was treated for viral fever and was started on domperidone 30 mg/day, sustained release form (0.7 mg/kg/day), for persistent vomiting along with other supportive treatment. On the fourth day of treatment, although the fever and vomiting subsided, the child developed oromandibular dystonia despite giving the drug in the recommended dose. Fortunately, drug-induced dystonias are a reversible condition and the child improved in 7-8 days after discontinuation of the drug. There was no recurrence at 1 month follow-up. Usually, dystonic reactions do not threaten life but are troublesome and life altering, so judicious use of the drug is advised.
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