Lymphocytic gastritis and its relationships with other gastrointestinal disorders

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.

Helicobacter pylori‐negative Chronic Gastritis in Children

“…LG has been found in association with a variety of disorders, such as coeliac disease, H pylori gastritis, HIV, Meanetrier's disease, NSAIDs, and also with angiotensin II receptor blockers suggesting an abnormal local immunologic response to different antigens as the underlying pathophysiologic mechanism (98,99). A recent large retrospective study in adults has, however, questioned the pathogenic role of H pylori infection (100). The prevalence of LG in children with coeliac disease ranges between 10% and 45% (101–105).…”

Guidelines for diagnosis and treatment of chronic gastritis inChina(2022,Shanghai)

“…Lymphocytic gastritis is characterized by non‐specific clinical manifestations, with common symptoms such as dyspepsia, epigastric pain, heartburn, vomiting, and weight loss. It is closely associated with H. pylori infection, and some patients may have concomitant celiac disease 63,64 …”

“…H. pylori infection, and some patients may have concomitant celiac disease. 63,64 Mild granulomatous gastritis is asymptomatic. However, when the lesion is large, patients may develop gastric ulcers or evacuation disorder, leading to epigastric pain, abdominal distension, nausea, vomiting, gastrointestinal bleeding, and anemia.…”

Insights into the underlying mechanisms and clinical management of microscopic colitis in relation to other gastrointestinal disorders

“…Whereas it is not a specific disease group, it is usually seen in coincidence with other lymphocytic disorders and is closely associated with MC [ 73 , 81 ]. A cross-sectional study including 3,038 patients with LyG reported that 19% of patients can develop MC as a co-morbidity [ 82 ]. DIL is the most common lymphocytic disorder of the gastrointestinal tract.…”