Lymphocytic gastritis: a rare disorder of the gastric mucosa

Lymphocytic gastritis, first described by Haot et al, in 1986, is a very ra re form of gastritis (0.8-1.6% of cases) with unclear pathogenesis. On endo scopy, lymphocytic gastritis may present either a normal appearance, such a s gastritis varioliformis with multiple elevated chronic erosions in the co rpus and fundus, or as a giant fold gastritis in the corpus and fundus. Thi s type of gastritis is diagnosed histologically based on an accumulation of intraepithelial lymphocytes (more than 25/100 epithelial cells) in the sur face cells of the gastric mucosa. Its etiopathogenesis is currently thought to be a sprue-associated reaction or an atypical reaction to Helicobacter pylori infection. Some studies report the lymphocytic gastritis in almost 4 5% of cases of sprue, with the gastritis regressing in response to a gluten -free diet,while others report a correlation of lymphocytic gastritis with serologically and/or histologically confirmed H.pylori infection,with the l ymphocytic gastritis being cured by H. pylori eradication treatment in a hi gh percentage of the cases. It is possible that a similar abnormal immune r eaction to an inflammatory agent underlies both pathological entities, spru e and lymphocytic gastritis - in the one case gluten and in the other H. py lori - which would mean that sprue-induced and H. pylori-induced forms of l ymphocytic gastritis exist side by side.