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.

LG, 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.

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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).

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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