FOCALLY ENHANCED GASTRITIS - A FREQUENT TYPE OF GASTRITIS IN PATIENTSWITH CROHNS-DISEASE

Background & Aims: Gastric histology is not well studied in patients w ith Crohn's disease. The aim of this study was to analyze the histolog ical appearance of gastric mucosa in patients with Crohn's disease. Me thods: In a prospective study, biopsy specimens taken from the antrum and body of 75 patients with known Crohn's disease of the large and/or small bowel and 200 Crohn's disease-free controls were evaluated by h istology and immunohistochemistry. Results: Helicobacter pylori-associ ated gastritis was found in 25 patients with Crohn's disease (33.3%) a nd 78 controls (39%). In H. pylori-negative patients with Crohn's dise ase, a characteristic type of gastritis was found in antral biopsy spe cimens of 36 patients (48%) and in body biopsy specimens of 18 patient s (24%). It was characterized by a focal infiltration of CD3(+) lympho cytes, CD68R(+) histiocytes, and, in 80% of cases, of granulocytes. Gr anulomas were found in 11 patients. Overall, granulomas and/or focally enhanced gastritis were observed in 76% of H. pylori-negative patient s with Crohn's disease and in 0.8% of controls. There were no correlat ions between the occurrence of focally enhanced gastritis and clinical and laboratory findings. Conclusions: Focally enhanced gastritis is c ommon in Crohn's disease. Its recognition should guide the clinician i nto further investigations in patients not yet known to have Crohn's d isease.