title: Lymphocytic esophagitis in children.
abstract: BACKGROUND
  Lymphocytic esophagitis (LE) is a term recently suggested for the finding of >20 intraepithelial lymphocytes/high-power field in an esophageal biopsy with no more than a rare granulocyte. Two prior studies of LE suggested an association of LE with Crohn's disease (CD) in young patients, but there has been no systematic review of a large pediatric cohort to determine the prevalence and clinical associations of LE in children.
  
  
  METHODS
  All esophageal biopsies performed at a tertiary care pediatric medical center in 2005 were identified (580 biopsies from 545 unique patients). A blinded histologic review was performed to identify LE cases (>50 intraepithelial lymphocytes/high-power field; <1 granulocyte/50 intraepithelial lymphocytes). Clinical characteristics, endoscopic findings, and follow-up data for each case were reviewed independently by a pediatric gastroenterologist.
  
  
  RESULTS
  Thirty-one patients with LE (5.7%) and 49 patients with CD (8.9%) were found among the 545 patients. Six of the 31 LE patients (19%) and 43 of the 514 non-LE patients (8.4%) had CD (P < 0.05). The remaining LE patients had various other clinical diagnoses with no significant clinical correlates. LE was identified in 6 of 49 patients with CD (12.2%) and 25 of 496 patients without CD (5.0%) (P < 0.05). Patients with both LE and CD had a more prominent lymphocytic infiltrate than LE patients without CD.
  
  
  CONCLUSIONS
  LE seems to be more prevalent in children than in adults and has a significant association with CD in this age group.
authors.affiliation: Department of *Pathology and †Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas; and Departments of ‡Pathology and §Pediatrics, Children's Medical Center Dallas, Dallas, Texas.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sutton
authors.forename: D Dyer
authors.initials: DD
authors.lastname: Heintz
authors.forename: Ashish S
authors.initials: AS
authors.lastname: Patel
authors.forename: Arthur G
authors.initials: AG
authors.lastname: Weinberg
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003424:Crohn Disease / Q000150:complications*; D004941:Esophagitis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology