Healing of Lymphocytic Gastritis by Eradication of <i>Helicobacter pylori</i>

Abstract

Background: It is not yet clear whether lymphocytic gastritis might not be a sequela of Helicobacter pylori (Hp) infection. The aim of the present pilot study was, therefore, to investigate whether lymphocytic gastritis can be cured by Hp eradication, which, if affirmed, would provide indirect evidence for an etiopathogenic relationship. Patients and Methods: 98 of 220 patients with lymphocytic gastritis diagnosed between 1988 and 1998 were investigated at least twice, with 61 of them undergoing Hp eradication treatment. In 29 of these patients, the pretreatment histological work-up using the Warthin-Starry silver stain revealed Hp colonisation, while in the remaining 32 patients the biopsies from the antrum and corpus were negative for Hp. The other 37 patients received no treatment, and served as a control group. Results: Both in the group with Hp-positive, and in the group with Hp-negative histology prior to treatment, eradication treatment led to healing of the gastritis, i.e. to regression of the gastritis parameters including normalisation of the intra-epithelial lymphocyte count, in 93.1% and 84.3% of the cases, respectively. In the control group the histological findings did not change. Conclusions: The results of our retrospective study support the notion that most cases of lymphocytic gastritis might be a consequence of Hp infection. This, however, needs to be clarified definitively by a prospective, randomized, double-blind study.

Rare Gastric Lesions Associated with Helicobacter pylori Infection: A Histopathological Review

“…In Western countries, LG and GG are generally classified as special forms of H. pylori –negative gastritis [3,4]. However, there is convincing evidence that H. pylori infection contributes to the pathogenesis of both LG [1,5] and GG [6,7,22], and that H. pylori eradication therapy may be an effective treatment [7,13-15,17,23,24]. Thus, it is possible that subsets of LG and GG could be categorized as H. pylori –associated gastritis.…”

“…Interestingly, a considerable number of patients with LG and positive H. pylori serology did not exhibit histological evidence of H. pylori infection [1,14,15,27]. In addition, the beneficial effects of H. pylori eradication therapy in LG have been observed in patients who had positive serology but negative histology for H. pylori [14,15].…”

“…In addition, the beneficial effects of H. pylori eradication therapy in LG have been observed in patients who had positive serology but negative histology for H. pylori [14,15]. Furthermore, even when H. pylori infection has been histologically confirmed in patients with LG, colonization tends to be mild and focal [14,15]. These results imply that failure to histologically detect H. pylori may be related to sampling error due to low-level infection [27].…”

Lymphocytic Gastritis Identified by Abnormal PET Scan

“…While the etiology of lymphocytic gastritis is unknown, it has important clinical associations with celiac disease and H. pylori infection 3,4. In these patients, H. pylori histology may have a reduced sensitivity, and it is recommended patients with lymphocytic gastritis and negative biopsies should undergo serologic testing 4,5. Eradication of H. pylori has been shown to be an effective treatment; in one randomized trial, 83% of patients achieved resolution at 3 months and 95.8% at 12 months compared to 53.8% with PPI alone 4.…”

Epithelial cell proliferation and glandular atrophy in lymphocytic gastritis: Effect ofH pyloritreatment

“…Most dyspeptic patients with LG are seropositive for Helicobacter pylori, indicating that LG may represent an atypical host immune response to the infection [6] . Cases associated with H pylori infection have been reported to respond to H pylori eradication treatment [7][8][9] . Gluten is one of the other suspected trigger factors in particular cases, and the prevalence of LG is high in patients with celiac disease, reaching levels up to 45 % in some series [10,11] .…”