Lymphocytic gastritis and associated small bowel disease: a diffuse lymphocytic gastroenteropathy?

Lynch, D. A. F.; Sobala, G. M.; Dixon, M. F.; Gledhill, A. W.; Jackson, P. C.; Crabtree, J. E.; Axon, Anthony

doi:10.1136/jcp.48.10.939

Cited by 73 publications

(25 citation statements)

References 31 publications

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“…As previous results revealed, LG could be the manifestation of H. pylori infection [9]. The results of our studies showed the frequency of H. pylori in the gastric mucosa of coeliac patients and in the control group as 20% and 55% respectively, which was lower than the results reported by other authors, 82% and 97% respectively [2].…”

Section: T Ta Ab Bl Le E I Ii Ii I Histological Lesions In the Gascontrasting

confidence: 56%

Mucosal lesions of the gastric mucosa in adult patients with coeliac disease

Zwolińska–Wcisło¹,

Tomaszewska²,

Rozpondek³

et al. 2012

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Section: T Ta Ab Bl Le E I Ii Ii I Histological Lesions In the Gascontrasting

confidence: 56%

Mucosal lesions of the gastric mucosa in adult patients with coeliac disease

Zwolińska–Wcisło¹,

Tomaszewska²,

Rozpondek³

et al. 2012

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“…The H&E stained sections were examined at ×400 magnification and the number of IELs and epithelial cell nuclei in an uninterrupted length of surface and foveolar epithelium were counted. Based on previous studies,3 5 the ratio of 25 IELs:100 epithelial cells was used as a limit for inclusion into this study. Gastritis was classified according to the updated Sydney System 9…”

Section: Methodsmentioning

confidence: 99%

Effects of Helicobacter pylori eradication on the natural history of lymphocytic gastritis

Hayat

Arora

Dixon

et al. 1999

Gut

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Background-Lymphocytic gastritis is characterised by an accumulation of lymphocytes in the surface epithelium of the stomach. Lymphocytic gastritis has been linked to coeliac disease and Helicobacter pylori infection. Aims-To determine whether H pylori eradication leads to resolution of the lymphocytic infiltrate and clinical improvement in patients with lymphocytic gastritis, and to determine their HLA status. Methods-The Leeds Dyspepsia Questionnaire (LDQ) was administered to 13 patients with lymphocytic gastritis. H pylori serology, 13C urea breath test (UBT), and upper gastrointestinal endoscopy with sampling of the duodenum, antrum, and corpus were done in all cases and the HLA status was determined. Eleven patients had at least one positive test for H pylori. Patients with lymphocytic gastritis and H pylori infection were treated with a one week course of omeprazole, clarithromycin, and metronidazole. Gastric and duodenal intraepithelial lymphocyte (IEL) counts were performed, along with histological assessment of gastric and duodenal biopsies before and after H pylori eradication. Results-Two months after treatment there was a significant reduction in gastric IEL counts in both antrum and corpus. There was no significant change in duodenal IEL counts before and after eradication. According to the Sydney grading there was significant improvement in corpus inflammation after eradication. The patients histologically H pylori positive before treatment became H pylori negative. Dyspepsia scores also improved significantly after treatment. Conclusions-H pylori eradication treatment in patients with lymphocytic gastritis causes significant improvement in the gastric IEL infiltrate, corpus inflammation, and dyspeptic symptoms. H pylori serology is frequently positive when histology and UBT are negative. Lymphocytic gastritis may represent a specific immune response to H pylori infection. (Gut 1999;45:495-498)

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“…Some authors, however, have speculated that there is an association with celiac disease [6, 19, 20, 21, 22, 23]. …”

Section: Introductionmentioning

confidence: 99%

“…This latter is always diagnosed when an increase in the number of intraepithelial lymphocytes (IEL) – more than 25 per 100 epithelial cells [4]– is found in the surface epithelium and the epithelium lining of the foveolae. These CD3+ T-lymphocytes may (1) be attracted by an increase in local MHC class I expression [5], (2) express CD8 in 80% of the T lymphocytes, and (3) often produce TIA 1 and granzyme B [6, 7], thus rendering them potentially cytotoxic. Endoscopically, three different findings have been described for lymphocytic gastritis: (1) Normal, or only slightly inflamed, mucosa [8]; (2) Varioliform gastritis with multiple raised chronic erosions – also known as ‘gastritis en nappes’ in the fundus and corpus [1, 2, 3, 8, 9, 10, 11, 12, 13].…”

Section: Introductionmentioning

confidence: 99%

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

Müller

Volkholz²,

Stolte³

2001

Digestion

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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.

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Lymphocytic gastritis and associated small bowel disease: a diffuse lymphocytic gastroenteropathy?

Cited by 73 publications

References 31 publications

Mucosal lesions of the gastric mucosa in adult patients with coeliac disease

Mucosal lesions of the gastric mucosa in adult patients with coeliac disease

Effects of Helicobacter pylori eradication on the natural history of lymphocytic gastritis

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

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