Chronic lymphocytic gastritis and protein losing gastropathy.

Abstract

Chronic lymphocytic gastritis (CLG) is a recently described histopathological entity characterised by the presence of lymphocytes in the surface and foveolar epithelium of the gastric mucosa. Previous accounts'-have paid attention to both the endoscopic and histological features of the condition but the presenting features and clinical correlates of the pathology have not been clearly characterised. In this report we describe a new clinical association which is supported by a second case with similar features of protein loss. This is also the first report of CLG in which lymphocytic infiltration has also been shown in the duodenal mucosa. Case 1The patient, D M, a 34 year old solicitor, presented to his general practitioner with slow recovery from a flu like illness. Although his own symptoms were few his wife volunteered her concern over his lifestyle of frenetic activity, running and cycling over 10 miles per day, eating very little and having lost 7 kg in weight over the previous six months. On examination he was clearly wasted and thin, weight 50 kg with absent body fat, muscle wasting and mild ankle oedema. He was thought to be suffering from anorexia nervosa and was referred for a hospital opinion.

Lymphocytic gastritis and associated small bowel disease: a diffuse lymphocytic gastroenteropathy?

“…Our results suggest that lymphocytic gastritis per se is associated with impaired small bowel function. This finding should prompt a re-appraisal of the reported link between lymphocytic gastritis and a protein losing gastropathy which was first recognised by Crampton et al 16 These authors described two patients in a protein losing state in whom there were thickened gastric folds with lymphocytic gastritis but no histological evidence of Menetrier's disease. Duodenal biopsy specimens showed a marked increase in IEL numbers.…”

Resolution of Gastrointestinal Protein Loss after Helicobacter pylori Eradication in a Patient with Hypertrophic Lymphocytic Gastritis

“…An association between lymphocytic gastritis and Helicobacter pylori infection or celiac disease has been found [5,8]. Lymphocytic giant fold gastritis is a rare cause for gastrointestinal protein loss [6,7]. Here, we describe a patient with H. pylori ‐associated hypertrophic lymphocytic gastritis, in whom gastrointestinal protein loss resolved completely following H. pylori eradication.…”

Ménétrier’s Disease of the Stomach: A Clinical Challenge

“…Another patient with systemic lupus erythematosus developed MD which promptly regressed during immunosuppressive therapy with systemic steroids and immunoglobulins [8]. Several authors reported MD occurring in the setting of chronic lymphocytic gastritis [6]. This entity may be associated with Helicobacter pylori infection, and eradication of the bacteria may result in spontaneous regression of the disease [1].…”