De Giacomo C, Gianatti A, Negrini R, Perotti P, Bawa P, Maggiore G, Fiocca R
Clinica Pediatrica, Universita di Pavia, Italy.
J Pediatr. 1994 Jan;124(1):57-62. doi: 10.1016/s0022-3476(94)70254-3.
Lymphocytic gastritis is characterized by lymphocytic infiltration of the surface and pit epithelium. Its cause has not been established, but an association with Helicobacter pylori infection or celiac disease has been suggested. We evaluated the histologic features of both gastric and duodenal biopsy specimens from 245 consecutive children and adolescents, and found chronic gastritis in 60 children and celiac disease in 25. Chronic gastritis was associated with H. pylori infection in 36 children and with celiac disease in 15. Lymphocytic gastritis was found in nine children with celiac disease. Children with lymphocytic gastritis had a mean of 40.64 lymphocytes per 100 epithelial cells, compared with a mean of 3.92 lymphocytes per 100 epithelial cells in children with H. pylori-associated gastritis and 5.15 lymphocytes in normal control subjects. Immunohistochemical studies showed that the intraepithelial lymphocytes in lymphocytic gastritis were T cells. No child with lymphocytic gastritis had serologic evidence of past H. pylori infection. We conclude that lymphocytic gastritis in children is associated with celiac disease. Dyspeptic symptoms are frequent; the endoscopic appearance is not characteristic.
淋巴细胞性胃炎的特征是表面和腺窝上皮的淋巴细胞浸润。其病因尚未明确，但有人提出与幽门螺杆菌感染或乳糜泻有关。我们评估了245名连续就诊的儿童和青少年的胃和十二指肠活检标本的组织学特征，发现60名儿童患有慢性胃炎，25名患有乳糜泻。36名儿童的慢性胃炎与幽门螺杆菌感染有关，15名与乳糜泻有关。在9名患有乳糜泻的儿童中发现了淋巴细胞性胃炎。淋巴细胞性胃炎患儿每100个上皮细胞中平均有40.64个淋巴细胞，相比之下，幽门螺杆菌相关性胃炎患儿每100个上皮细胞中平均有3.92个淋巴细胞，正常对照受试者中有5.15个淋巴细胞。免疫组织化学研究表明，淋巴细胞性胃炎中的上皮内淋巴细胞是T细胞。没有淋巴细胞性胃炎患儿有既往幽门螺杆菌感染的血清学证据。我们得出结论，儿童淋巴细胞性胃炎与乳糜泻有关。消化不良症状很常见；内镜表现无特征性。
