儿童患者的胶原性和淋巴细胞性胃炎。单中心经验观察到近年来诊断增加。

Collagenous and lymphocytic gastritis in pediatric patients. A single-center experience observing an increase in diagnosis in recent years.

机构信息

Department of Pediatrics, Kaplan Medical Center, Rehovot, Israel.

Institute of Pathology, Kaplan Medical Center, Rehovot, Israel.

出版信息

Scand J Gastroenterol. 2024 Oct;59(10):1144-1150. doi: 10.1080/00365521.2024.2395858. Epub 2024 Aug 29.

DOI:10.1080/00365521.2024.2395858

PMID:39206869

Abstract

BACKGROUND

Collagenous gastritis (CG) and Lymphocytic gastritis (LG) are rare types of gastritis. Thick sub-epithelial collagen bands characterize CG. Numerous lymphocytes in the surface and foveolar epithelium characterize LG. We aimed to characterize these disorders in our pediatric unit.

METHODS

A retrospective review of children diagnosed with CG and LG between 2000 and 2023. Baseline data; demographics, anthropometric, symptoms, laboratory data, macroscopic and histopathologic findings. Follow-up data; treatment, improvement of symptoms and laboratory parameters.

RESULTS

We identified 31 children, 11 (35.5%) had CG and 20 (64.5%) LG, mean age 9.07 ± 5.04 years. Seven (22.6%) children were diagnosed between 2000 and 2016 and 24 (77.4%) between 2017 and 2023. Baseline characteristics included gastrointestinal symptoms in 16 (51.6%), iron deficiency anemia in 22 (71%), with a mean hemoglobin level of 8.8 ± 2.5 gr/dl. Gastric endoscopic findings were normal in 12 (38.7%), demonstrated nodularity in 14 (45.2%) and an inflamed mucosa without nodularity in 5 (16.1%). was positive in 3 (9.7%) children, celiac disease was diagnosed in 7 (22.6%). Treatment included iron supplementation in 24 (77.4%), proton pump inhibitors in 16 (51.6%) and a gluten free diet in seven. Mean follow-up was 2.9 ± 2.2 years. Hemoglobin levels normalized in 21/22; however, 9 (29%) patients required repeat iron supplementation. Eight patients had a repeat endoscopy (6 CG and 2 LG) without changes in their gastric histopathology.

CONCLUSIONS

CG and LG are not rare in pediatric patients. Physicians and pathologist should be aware of these types of gastritis.

摘要

背景

胶原性胃炎（CG）和淋巴细胞性胃炎（LG）是罕见的胃炎类型。CG 的特征是上皮下有厚的胶原带。LG 的特征是表面和小凹上皮中有大量淋巴细胞。我们旨在描述我们儿科病房中的这些疾病。

方法

对 2000 年至 2023 年间诊断为 CG 和 LG 的儿童进行回顾性研究。基线数据包括人口统计学、体格测量、症状、实验室数据、宏观和组织病理学发现。随访数据包括治疗、症状和实验室参数的改善。

结果

我们共发现 31 例患儿，11 例（35.5%）为 CG，20 例（64.5%）为 LG，平均年龄 9.07±5.04 岁。7 例（22.6%）患儿在 2000 年至 2016 年间确诊，24 例（77.4%）在 2017 年至 2023 年间确诊。基线特征包括 16 例（51.6%）胃肠道症状，22 例（71%）缺铁性贫血，平均血红蛋白水平为 8.8±2.5g/dl。12 例（38.7%）患儿胃镜检查正常，14 例（45.2%）表现为结节状，5 例（16.1%）表现为无结节状炎症性黏膜。3 例（9.7%）患儿粪便钙卫蛋白阳性，7 例（22.6%）患儿诊断为乳糜泻。治疗包括 24 例（77.4%）补铁，16 例（51.6%）质子泵抑制剂，7 例（22.6%）无麸质饮食。平均随访 2.9±2.2 年。21/22 例血红蛋白水平正常，但 9 例（29%）患儿需要重复补铁。8 例患儿再次行胃镜检查（6 例 CG，2 例 LG），胃组织病理学无变化。