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Lymphocytic Gastritis Strongly Associated with Celiac Disease

Celiac.com 07/20/2015 - Lymphocytic gastritis (LG) is an uncommon gastric disorder with varying symptoms and endoscopic manifestations.

Image: Wikimedia CommonsLG, along with two forms of H. pylori-negative gastritis [chronic active gastritis (CAG) and chronic inactive gastritis (CIG)], appears to be more common in patients with celiac disease, based on single-center studies.

A team of researchers set out to compare the prevalence of LG, CAG and CIG among those with normal duodenal histology or non-specific duodenitis, and those with celiac disease, as defined by villous atrophy, Marsh 3. The research team included B. Lebwohl, P. H. R. Green, and R. M. Genta. The are variously affiliated with The Department of Medicine, Coeliac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY, The Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA, the Miraca Life Sciences, Irving, TX, USA, and the Departments of Pathology and Medicine (Gastroenterology), UT Southwestern Medical Center, Dallas, TX, USA

The team analyzed all concurrent gastric and duodenal biopsy specimens submitted to a national pathology laboratory during a 6-year period. They then performed multiple logistic regression to identify independent predictors of each gastritis subtype.

They found that a total of 287,503 patients underwent concurrent gastric and duodenal biopsy, with an average age of 52, and most (67%) being female. Compared to patients with normal duodenal histology, LG was more common in partial villous atrophy (OR: 37.66; 95% CI: 30.16–47.03), and subtotal/total villous atrophy (OR: 78.57; 95% CI: 65.37–94.44).

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Celiac disease was also more common in CAG (OR for partial villous atrophy 1.93; 95% CI: 1.49–2.51, OR for subtotal/total villous atrophy 2.42; 95% CI: 1.90–3.09) and was similarly associated with CIG (OR for partial villous atrophy 2.04; 95% CI: 1.76–2.35, OR for subtotal/total villous atrophy 2.96; 95% CI: 2.60–3.38).

From this study, the team concluded that lymphocytic gastritis is strongly associated with celiac disease, with increasing prevalence correlating with more advanced villous atrophy.

Chronic active gastritis and chronic inactive gastritis are also significantly associated with celiac disease.

Future research should measure the natural history of these conditions after treatment with a gluten-free diet.

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2 Responses:

 
Avrel Ford
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said this on
09 Nov 2015 11:02:54 PM PDT
Thank you for your article, I have recently been diagnosed with chronic lymphocytic gastritis without helicobacter pylori, unfortunately both the doctor and the gastroenterologist can advise me on how to treat it, I have been as gluten free for 13 years of course some slips in by mistake every now and then and I pay the price. I think that they have put me in the too hard basket, I would appreciate any information that you would like to share with me. Thank you.

 
kim c
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said this on
07 May 2016 6:32:07 AM PDT
My son has lymphocytic gastritis diagnosed at age 6 and cows milk enteropathy, mild autism. My daughter was diagnosed at age 2 with celiac disease and cmpe also. Both had various reflux symptoms as a baby and vomited with too many amines while my son was still having small exposures to gluten. Most problems have resolved since eliminating gluten, dairy, going lower amine and starting omeprazole. My gastroenterologist and medical articles say the reduction in acid allows the lining to heal and at least my son no longer has trouble sleeping. It has also increased both their appetites and growth partly because there's a lower fluid volume as a result of omeprazole treating the higher volume that can occur with autism. My daughter also had ss caps put on her two back teeth at age 3 either due to the silent reflux or celiac disease or both. The omeprazole also has eliminated my daughters oral-nasal symptoms as reflux can also be an aerosol irritant and cause asthma. We are also suspicious of folate as being an additional problem and are seeing improved growth after removing artificial sources from their diet. My son is soon to be investigated further for subclinical hypothyroidism and growth failure.




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