Celiac disease is highly prevalent in lymphocytic colitis.
Matteoni CA, Goldblum JR, Wang N, Brzezinski A, Achkar E, Soffer EE.
Department of Gastroenterology, Cleveland Clinic Foundation, Ohio, USA.
A high frequency of celiac disease is reported in patients with collagenous colitis. Limited information is available on the frequency of celiac disease in lymphocytic colitis. The aim of our study was to determine the prevalence of celiac disease in microscopic colitis (collagenous and lymphocytic colitis). Patients were identified from a pathology registry of microscopic colitis from 1987 to 1999. Pathology reports and medical records were reviewed for previous small bowel biopsies and/or celiac serology. We identified 113 patients with microscopic colitis, and 46 patients underwent a small bowel biopsy and/or celiac serology. Of these, 27 patients had lymphocytic colitis (63% female; age, 58.6 +/- 16.2 years) and 19 patients had collagenous colitis (79% female; age, 61.8 +/- 13.6 years). Small bowel biopsy alone was performed in 28 of 46 patients, celiac serology alone was performed in 10, and both small bowel biopsy and celiac serology were performed in 8. Celiac disease was identified in 4 patients by small bowel histology; all had lymphocytic colitis (4 of 27 patients, 15%). This frequency of celiac disease is significantly higher than the highest reported U.S. prevalence of celiac disease (4/1,000 individuals; p < 0.01). There is a high frequency of celiac disease in patients with lymphocytic colitis. Given the importance of the early detection of celiac disease, it should be excluded in all patients with lymphocytic colitis, particularly if diarrhea does not respond to conventional treatment.
J Clin Gastroenterol. 2001 Mar;32(3):193-5.
Celiac disease is highly prevalent in lymphocytic colitis.
Moderators: Rosie, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh, mbeezie
Celiac disease is highly prevalent in lymphocytic colitis.
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Here are some more related studies on lymphocytic gastritis / colitis ... and gluten:
A 25-year-old patient presented with epigastric pain, which on gastric biopsy revealed the characteristic appearance of collagenous gastritis. There was a thick prominent subepithelial band that was confirmed to be collagen with a Masson's trichrome stain. There was associated Helicobacter pylori gastritis but no evidence of a lymphocytic gastritis. The patient did not have watery diarrhea. Collagenous gastritis can occur in young patients, be restricted to the stomach, and can be associated with celiac disease.
Collagenous Gastritis.
PMID: 19103610 Dec 2008
Lymphocytic gastritis and celiac disease in indian children: evidence of a positive relation.
PMID: 18979579 Nov 2008
Lymphocytic gastritis represents a small subset among the numerous gastridities.[4] Its reported frequency in routine practice is 1% to 9% among patients undergoing endoscopy for dyspepsia and 15% to 45% among patients with celiac disease (also known as celiac sprue).[3] Differentiation between lymphocytic gastritis and other chronic gastritides and normal mucosa requires documenting intraepithelial lymphocytes, with the intraepithelial lymphocytes numbering approximately 20 to 30 per 100 epithelial cells.
The cause of lymphocytic gastritis is unknown. The most common disease associations include celiac sprue and H pylori infection. Approximately one third of patients with lymphocytic gastritis have concomitant celiac sprue; approximately 10% to 30% of patients with celiac sprue have lymphocytic gastritis.[12,18,19] It has been suggested that lymphocytic gastritis represents a host response to an intraluminal antigen, either gluten or another.[2] Hayat and colleagues[20] have found similar HLA antigens in both celiac sprue and lymphocytic gastritis.
In summary, lymphocytic gastritis is an uncommon form of gastritis that may be an incidental finding at endoscopy or be a cause of hypoalbuminemia, gastrointestinal bleeding, anorexia, or weight loss. The discovery of lymphocytic gastritis should prompt clinical consideration of celiac sprue. Serologic testing for H pylori should also be performed and treatment initiated if results are positive.
Grand Rounds in Gastroenterology from Baylor College of Medicine - A Man With Rheumatoid Arthritis and Iron-Deficiency Anemia (Medscape) 2007
Lymphocytic gastritis (LG) is defined by the recognition of >25 intraepithelial lymphocytes (IEL) per 100 surface epithelial cells. Approximately 50% of children with celiac disease (CD) present LG, which mainly involves the gastric antrum and disappears after a gluten-free diet.
Lymphocytic gastritis in pediatric celiac disease - immunohistochemical study of the intraepithelial lymphocytic component.
PMID: 14704635 Jan 2004
Lymphocytic gastritis is a distinctive pattern of inflammation that resembles that seen in celiac disease and lymphocytic colitis
Emerging gastritides.
PMID: 11696291 Dec 2001
Some studies report the lymphocytic gastritis in almost 45% of cases of sprue, with the gastritis regressing in response to a gluten-free diet, while others report a correlation of lymphocytic gastritis with serologically and/or histologically confirmed H. pylori infection, with the lymphocytic gastritis being cured by H. pylori eradication treatment in a high percentage of the cases
Lymphocytic gastritis--a rare disorder of the gastric mucosa.
PMID: 11225446 Jan 2001
The pattern of involvement of gastric mucosa in lymphocytic gastritis is closely related to the associated duodenal pathology.
The pattern of involvement of the gastric mucosa in lymphocytic gastritis is predictive of the presence of duodenal pathology.
PMID: 10690170 Nov 1999
Lymphocytic gastritis occurred in 10% of patients with coeliac disease.
Lymphocytic gastritis and coeliac disease: evidence of a positive association.
PMID: 9659261 Mar 1998
There is a high prevalence of lymphocytic gastritis in untreated celiac disease associated with elevated gastric permeability. Celiac disease seems to be a general disorder of the gastrointestinal tract associated with disturbed permeability.
Lymphocytic gastritis and gastric permeability in patients with celiac disease.
PMID: 8698227 Jul 1996
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
Lymphocytic gastritis: a positive relationship with celiac disease.
PMID: 8283376 Jan 1994
This is a type of chronic gastritis with dense infiltration of the surface and foveolar epithelium by T lymphocytes, and associated chronic infiltrates are in the lamina propria. Because of similar histopathology relative to celiac disease, lymphocytic gastritis has been proposed to result from intraluminal antigens. High anti–H pylori antibody titers have been found in patients with lymphocytic gastritis, and, in limited studies, the inflammation disappeared after H pylori eradication. However, many patients with lymphocytic gastritis are serologically negative for H pylori. A number of cases may develop secondary to intolerance to gluten and drugs such as ticlopidine.
Lymphocytic gastritis
On Lymphocytic Colitis:
There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented short-term treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.
Diagnosis and management of microscopic colitis.
PMID: 19109861 Dec 2008
Common disease associations include celiac disease, lymphocytic colitis, and autoimmune enteropathy. Pediatric colonic intraepithelial lymphocytosis, in the absence of other histologic findings, is associated with various diseases, including celiac disease, lymphocytic colitis, and autoimmune enteropathy. Colonic intraepithelial lymphocytosis in the presence of other inflammatory changes indicates the possibility of idiopathic inflammatory bowel disease. These findings are similar to those seen in adults, with the exception of autoimmune enteropathy.
Clinical significance of colonic intraepithelial lymphocytosis in a pediatric population.
PMID: 19116628 Jan 2009
Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur.
Complications of collagenous colitis.
PMID: 18350593 March 2008
CONCLUSIONS: Intraepithelial lymphocytosis in an otherwise normal small bowel biopsy is somewhat nonspecific, but in nearly 10% of cases can be the initial presentation of GS. Therefore all patients with this finding should be investigated for GS. Increased IELs may also be associated with autoimmune disorders and NSAIDs.
Significance of intraepithelial lymphocytosis in small bowel biopsy samples with normal mucosal architecture. PMID: 14499783 Sept 2003
Seventy nine (40%) patients reported associated diseases, of which thyroid disorders, coeliac disease, and diabetes mellitus were the most common.
Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients. PMID: 15016748
If there is no abatement of symptoms, rule out other etiologies of diarrhea such as thyroid dysfunction, celiac disease, or bacterial overgrowth
Lymphocytic and Collagenous Colitis. PMID: 11097741
A shared set of predisposing HLA-DQ genes account for the epidemiological overlap of celiac sprue and microscopic colitis.Although further studies will be necessary to determine if this enteropathy is induced by dietary gluten, we speculate that the small intestinal but not colonic histopathology in patients with microscopic colitis is caused by immunological gluten sensitivity.
High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome.
PMID: 10950045
Symptomatic remission was induced with a gluten/lactose-free diet, oral prednisone, and sulfasalazine and has been maintained with gluten restriction alone. We propose that, in this instance, collagenous enterocolitis represented a diffuse manifestation of gluten sensitivity
Collagenous enterocolitis: a manifestation of gluten-sensitive enteropathy PMID: 1500661
Links to the above PubMed abstracts can be found here: http://jccglutenfree.googlepages.com/crohn%27s,ibd,ibs
A 25-year-old patient presented with epigastric pain, which on gastric biopsy revealed the characteristic appearance of collagenous gastritis. There was a thick prominent subepithelial band that was confirmed to be collagen with a Masson's trichrome stain. There was associated Helicobacter pylori gastritis but no evidence of a lymphocytic gastritis. The patient did not have watery diarrhea. Collagenous gastritis can occur in young patients, be restricted to the stomach, and can be associated with celiac disease.
Collagenous Gastritis.
PMID: 19103610 Dec 2008
Lymphocytic gastritis and celiac disease in indian children: evidence of a positive relation.
PMID: 18979579 Nov 2008
Lymphocytic gastritis represents a small subset among the numerous gastridities.[4] Its reported frequency in routine practice is 1% to 9% among patients undergoing endoscopy for dyspepsia and 15% to 45% among patients with celiac disease (also known as celiac sprue).[3] Differentiation between lymphocytic gastritis and other chronic gastritides and normal mucosa requires documenting intraepithelial lymphocytes, with the intraepithelial lymphocytes numbering approximately 20 to 30 per 100 epithelial cells.
The cause of lymphocytic gastritis is unknown. The most common disease associations include celiac sprue and H pylori infection. Approximately one third of patients with lymphocytic gastritis have concomitant celiac sprue; approximately 10% to 30% of patients with celiac sprue have lymphocytic gastritis.[12,18,19] It has been suggested that lymphocytic gastritis represents a host response to an intraluminal antigen, either gluten or another.[2] Hayat and colleagues[20] have found similar HLA antigens in both celiac sprue and lymphocytic gastritis.
In summary, lymphocytic gastritis is an uncommon form of gastritis that may be an incidental finding at endoscopy or be a cause of hypoalbuminemia, gastrointestinal bleeding, anorexia, or weight loss. The discovery of lymphocytic gastritis should prompt clinical consideration of celiac sprue. Serologic testing for H pylori should also be performed and treatment initiated if results are positive.
Grand Rounds in Gastroenterology from Baylor College of Medicine - A Man With Rheumatoid Arthritis and Iron-Deficiency Anemia (Medscape) 2007
Lymphocytic gastritis (LG) is defined by the recognition of >25 intraepithelial lymphocytes (IEL) per 100 surface epithelial cells. Approximately 50% of children with celiac disease (CD) present LG, which mainly involves the gastric antrum and disappears after a gluten-free diet.
Lymphocytic gastritis in pediatric celiac disease - immunohistochemical study of the intraepithelial lymphocytic component.
PMID: 14704635 Jan 2004
Lymphocytic gastritis is a distinctive pattern of inflammation that resembles that seen in celiac disease and lymphocytic colitis
Emerging gastritides.
PMID: 11696291 Dec 2001
Some studies report the lymphocytic gastritis in almost 45% of cases of sprue, with the gastritis regressing in response to a gluten-free diet, while others report a correlation of lymphocytic gastritis with serologically and/or histologically confirmed H. pylori infection, with the lymphocytic gastritis being cured by H. pylori eradication treatment in a high percentage of the cases
Lymphocytic gastritis--a rare disorder of the gastric mucosa.
PMID: 11225446 Jan 2001
The pattern of involvement of gastric mucosa in lymphocytic gastritis is closely related to the associated duodenal pathology.
The pattern of involvement of the gastric mucosa in lymphocytic gastritis is predictive of the presence of duodenal pathology.
PMID: 10690170 Nov 1999
Lymphocytic gastritis occurred in 10% of patients with coeliac disease.
Lymphocytic gastritis and coeliac disease: evidence of a positive association.
PMID: 9659261 Mar 1998
There is a high prevalence of lymphocytic gastritis in untreated celiac disease associated with elevated gastric permeability. Celiac disease seems to be a general disorder of the gastrointestinal tract associated with disturbed permeability.
Lymphocytic gastritis and gastric permeability in patients with celiac disease.
PMID: 8698227 Jul 1996
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
Lymphocytic gastritis: a positive relationship with celiac disease.
PMID: 8283376 Jan 1994
This is a type of chronic gastritis with dense infiltration of the surface and foveolar epithelium by T lymphocytes, and associated chronic infiltrates are in the lamina propria. Because of similar histopathology relative to celiac disease, lymphocytic gastritis has been proposed to result from intraluminal antigens. High anti–H pylori antibody titers have been found in patients with lymphocytic gastritis, and, in limited studies, the inflammation disappeared after H pylori eradication. However, many patients with lymphocytic gastritis are serologically negative for H pylori. A number of cases may develop secondary to intolerance to gluten and drugs such as ticlopidine.
Lymphocytic gastritis
On Lymphocytic Colitis:
There is an association with other autoimmune disorders such as celiac disease, diabetes mellitus, thyroid disorders and arthritis. Budesonide is the best-documented short-term treatment, but the optimal long-term strategy needs further study. The long-term prognosis is good and the risk of complications including colonic cancer is low.
Diagnosis and management of microscopic colitis.
PMID: 19109861 Dec 2008
Common disease associations include celiac disease, lymphocytic colitis, and autoimmune enteropathy. Pediatric colonic intraepithelial lymphocytosis, in the absence of other histologic findings, is associated with various diseases, including celiac disease, lymphocytic colitis, and autoimmune enteropathy. Colonic intraepithelial lymphocytosis in the presence of other inflammatory changes indicates the possibility of idiopathic inflammatory bowel disease. These findings are similar to those seen in adults, with the exception of autoimmune enteropathy.
Clinical significance of colonic intraepithelial lymphocytosis in a pediatric population.
PMID: 19116628 Jan 2009
Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur.
Complications of collagenous colitis.
PMID: 18350593 March 2008
CONCLUSIONS: Intraepithelial lymphocytosis in an otherwise normal small bowel biopsy is somewhat nonspecific, but in nearly 10% of cases can be the initial presentation of GS. Therefore all patients with this finding should be investigated for GS. Increased IELs may also be associated with autoimmune disorders and NSAIDs.
Significance of intraepithelial lymphocytosis in small bowel biopsy samples with normal mucosal architecture. PMID: 14499783 Sept 2003
Seventy nine (40%) patients reported associated diseases, of which thyroid disorders, coeliac disease, and diabetes mellitus were the most common.
Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients. PMID: 15016748
If there is no abatement of symptoms, rule out other etiologies of diarrhea such as thyroid dysfunction, celiac disease, or bacterial overgrowth
Lymphocytic and Collagenous Colitis. PMID: 11097741
A shared set of predisposing HLA-DQ genes account for the epidemiological overlap of celiac sprue and microscopic colitis.Although further studies will be necessary to determine if this enteropathy is induced by dietary gluten, we speculate that the small intestinal but not colonic histopathology in patients with microscopic colitis is caused by immunological gluten sensitivity.
High prevalence of celiac sprue-like HLA-DQ genes and enteropathy in patients with the microscopic colitis syndrome.
PMID: 10950045
Symptomatic remission was induced with a gluten/lactose-free diet, oral prednisone, and sulfasalazine and has been maintained with gluten restriction alone. We propose that, in this instance, collagenous enterocolitis represented a diffuse manifestation of gluten sensitivity
Collagenous enterocolitis: a manifestation of gluten-sensitive enteropathy PMID: 1500661
Links to the above PubMed abstracts can be found here: http://jccglutenfree.googlepages.com/crohn%27s,ibd,ibs