Lisa M Sutton1, D Dyer Heintz, Ashish S Patel, Arthur G Weinberg. 1. Department of *Pathology and †Pediatrics, University of Texas Southwestern Medical School, Dallas, Texas; and Departments of ‡Pathology and §Pediatrics, Children's Medical Center Dallas, Dallas, Texas.
Abstract
BACKGROUND: Lymphocytic esophagitis (LE) is a term recently suggested for the finding of >20 intraepithelial lymphocytes/high-power field in an esophageal biopsy with no more than a rare granulocyte. Two prior studies of LE suggested an association of LE with Crohn's disease (CD) in young patients, but there has been no systematic review of a large pediatric cohort to determine the prevalence and clinical associations of LE in children. METHODS: All esophageal biopsies performed at a tertiary care pediatric medical center in 2005 were identified (580 biopsies from 545 unique patients). A blinded histologic review was performed to identify LE cases (>50 intraepithelial lymphocytes/high-power field; <1 granulocyte/50 intraepithelial lymphocytes). Clinical characteristics, endoscopic findings, and follow-up data for each case were reviewed independently by a pediatric gastroenterologist. RESULTS: Thirty-one patients with LE (5.7%) and 49 patients with CD (8.9%) were found among the 545 patients. Six of the 31 LE patients (19%) and 43 of the 514 non-LE patients (8.4%) had CD (P < 0.05). The remaining LE patients had various other clinical diagnoses with no significant clinical correlates. LE was identified in 6 of 49 patients with CD (12.2%) and 25 of 496 patients without CD (5.0%) (P < 0.05). Patients with both LE and CD had a more prominent lymphocytic infiltrate than LE patients without CD. CONCLUSIONS: LE seems to be more prevalent in children than in adults and has a significant association with CD in this age group.
BACKGROUND:Lymphocytic esophagitis (LE) is a term recently suggested for the finding of >20 intraepithelial lymphocytes/high-power field in an esophageal biopsy with no more than a rare granulocyte. Two prior studies of LE suggested an association of LE with Crohn's disease (CD) in young patients, but there has been no systematic review of a large pediatric cohort to determine the prevalence and clinical associations of LE in children. METHODS: All esophageal biopsies performed at a tertiary care pediatric medical center in 2005 were identified (580 biopsies from 545 unique patients). A blinded histologic review was performed to identify LE cases (>50 intraepithelial lymphocytes/high-power field; <1 granulocyte/50 intraepithelial lymphocytes). Clinical characteristics, endoscopic findings, and follow-up data for each case were reviewed independently by a pediatric gastroenterologist. RESULTS: Thirty-one patients with LE (5.7%) and 49 patients with CD (8.9%) were found among the 545 patients. Six of the 31 LEpatients (19%) and 43 of the 514 non-LEpatients (8.4%) had CD (P < 0.05). The remaining LEpatients had various other clinical diagnoses with no significant clinical correlates. LE was identified in 6 of 49 patients with CD (12.2%) and 25 of 496 patients without CD (5.0%) (P < 0.05). Patients with both LE and CD had a more prominent lymphocytic infiltrate than LEpatients without CD. CONCLUSIONS:LE seems to be more prevalent in children than in adults and has a significant association with CD in this age group.
Authors: Juan Putra; Kristen E Muller; Zilla H Hussain; Siddhartha Parker; Scott Gabbard; Elizabeth B Brickley; Brian E Lacy; Richard Rothstein; Mikhail Lisovsky Journal: Am J Surg Pathol Date: 2016-12 Impact factor: 6.394
Authors: Sarina Pasricha; Amit Gupta; Craig C Reed; Olga Speck; John T Woosley; Evan S Dellon Journal: Dig Dis Sci Date: 2016-06-24 Impact factor: 3.199