Lymphocytic gastritis and celiac disease in indian children: evidence of a positive relation.
OBJECTIVE
Lymphocytic gastritis (LG) is characterized by the presence of > or = 25 lymphocytes/100 epithelial cells in the gastric surface and pit epithelium. An association of LG with Helicobacter pylori infection or celiac disease (CD) has been suggested. The aim of this study was to verify the relation of LG with CD, with and without H pylori infection, in children.


METHODS
A total of 164 children with CD diagnosed between June 2003 and October 2005, in whom gastric and duodenal biopsies were performed simultaneously, were enrolled prospectively. The control group was composed of 164 children without CD, matched for sex and age, who were undergoing upper digestive endoscopy. H pylori was searched for in gastric biopsy specimens sectioned and stained with hematoxylin and eosin, and a modified Giemsa stain for H pylori was performed for confirmation. The Student t test was used to compare quantitative measurements between groups.


RESULTS
LG was found in 69 (42.1%) patients with CD. Positive cases had a mean of 43.9 +/- 1.5 intraepithelial lymphocytes per 100 surface epithelial cells, compared with a mean of 13.4 +/- 0.4 in negative cases and 7.8 +/- 0.5 in non-CD control children (P<0.0001). Patients not showing LG did, however, show significantly increased gastric intraepithelial lymphocytes compared with the control children. Nine of 164 CD patients, and 4 of 69 patients with LG, had positive results for H pylori.


CONCLUSIONS
This study supports a pathogenetic relation between CD and LG. CD without LG also showed increased gastric intraepithelial lymphocytes. H pylori infection may be another cause of LG in children.
Prasad
Kaushal K
KK
Division of GE Histopathology, Department of Superspecialty of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. kaushalkp10@hotmail.com
Thapa
Babu R
BR
Lal
Sadhna
S
Sharma
Arun K
AK
Nain
Chander K
CK
Singh
Kartar
K
D001706:Biopsy; D002446:Celiac Disease / Q000150:complications* / Q000473:pathology; D002648:Child; D002908:Chronic Disease; D004378:Duodenal Diseases / Q000150:complications* / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000150:complications* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications* / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D007194:India; D008214:Lymphocytes / Q000473:pathology*; D011446:Prospective Studies; D013270:Stomach / Q000473:pathology