10-YEAR FOLLOW-UP-STUDY OF LYMPHOCYTIC GASTRITIS - FURTHER EVIDENCE ON HELICOBACTER-PYLORI AS A CAUSE OF LYMPHOCYTIC GASTRITIS AND CORPUS GASTRITIS

Aims-To examine the course of lymphocytic gastritis and its relation t o Helicobacter pylori (H pylori) infection in a 10 year follow up. Met hods-Ninety six patients were originally examined for dyspepsia in 198 1. Gastroscopies with stepwise biopsies were performed on all the pati ents initially and after an interval of 10 years. Results-Nine per cen t of the patients (9/96) had features of lymphocytic gastritis in gast ric biopsy at the first examination, and 12.5% (12/96) at the second e xamination; 7/9 patients (78%) had persistent lymphocytic gastritis du ring the follow up; in two the diagnostic features of lymphocytic gast ritis had disappeared, and five had a new diagnosis of lymphocytic gas tritis at the second examination. At the second examination 9/12 lymph ocytic gastritis patients (75%) were H pylori positive histologically, while all had specific antibodies to H pylori. The lymphocytic gastri tis patients had higher grades of gastritis (p = 0.009), neutrophilic and eosinophilic granulocytes, mononuclear inflammatory cells, and fov eolar hyperplasia in the corpus mucosa, but smaller numbers of H pylor i, than the H pylori positive patients without lymphocytic gastritis. The appearance of lymphocytic gastritis during the 10 year interval wa s associated with increases in the grades of corpus gastritis and neut rophilic granulocytes (p = 0.043 for both). During the follow up, the patients with lymphocytic gastritis, but not the H pylori positive pat ients without lymphocytic gastritis, appeared to have a significant in crease in the grade of intestinal metaplasia in the corpus mucosa (p = 0.043). Conclusions-In some patients H pylori may cause a gastritis t hat predominates in the corpus and is associated with an increase in t he intraepithelial lymphocyte count. This form of gastritis may cause progression of intestinal metaplasia.