Lymphocytic gastritis and its relationships with other gastrointestinal disorders.

Aliment Pharmacol Ther

Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, OR, USA.

Published: November 2021

AI Article Synopsis

  • Lymphocytic gastritis (LyG) is a histopathological finding that lacks clear clinical significance but has a prevalence of 0.21% among a study of 1.5 million patients, with a higher occurrence in males and those aged 50-70.
  • LyG shows associations with conditions like Helicobacter pylori infection, coeliac disease, and microscopic colitis, with gastrointestinal symptoms like anemia, diarrhea, and weight loss more common in affected individuals.
  • The majority of LyG cases are believed to be self-limiting, often resolving within a year, regardless of the presence of H. pylori infection.

Article Abstract

Background: Lymphocytic gastritis (LyG) is a histopathologic finding of unknown clinical relevance.

Aims: To explore the clinical epidemiology of LyG and its associations with Helicobacter pylori (Hp) infection, coeliac disease (CD) and microscopic colitis (MC) METHODS: In a cross-sectional study, the demographic, clinical, and histopathologic data of patients with and without LyG were compared. Between 2008 and 2020, 1.5 million patients with endoscopic biopsies of the gastroduodenal mucosa were extracted from a database. LyG diagnoses were reviewed to collect detailed information regarding its topographic distribution within the stomach. In a large subgroup of 400 000 patients, tissue samples from the colon were also available.

Results: Of 1 481 336 patients, 341 had LyG with Hp and 2697 had Hp-negative LyG (with an overall prevalence of 0.21%). In patients with Hp-negative LyG, 450 (17%) had corpus-predominant LyG, 1068 antrum-predominant LyG (40%), and 1179 pangastric LyG (44%). LyG was more common in males and in subjects aged 50-70 years. There was no significant ethnic variation. Anaemia, diarrhoea, and weight loss were more common in patients with than without LyG. In 35% and 19% of patients, LyG was associated with CD and MC, respectively. All 72 patients with Hp-positive LyG and 280 of 310 patients with Hp-negative LyG with follow-up biopsies became free of LyG within a year.

Conclusions: Most cases of LyG may represent a self-limited expression, frequently associated with other GI conditions, such as Hp infection, CD, and MC. In most patients, LyG is likely to resolve within a year after its initial diagnosis.

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http://dx.doi.org/10.1111/apt.16621DOI Listing

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