Lymphocytic esophagitis: a diagnosis of increasing frequency

Despite being found with increasing frequency on esophageal biopsies, the clinical significance of lymphocytic esophagitis (LE) remains poorly understood.

The primary aim of our study was to characterize the clinical presentation and natural history of LE among adult patients.

We retrospectively reviewed records for all 81 adult patients at the University of Michigan Medical Center who had a histopathologic diagnosis of LE between January 1998 and November 2009. Patient demographics, clinical history, laboratory data, and imaging results from the time of diagnosis were obtained through review of computerized medical records. A telephone survey was conducted to collect natural history data.

The number of LE diagnoses increased over time, with 81.5% (n=66) of patients being diagnosed in the last 3 years. The most frequent symptoms at the time of presentation were dysphagia (n=54), chest/abdominal pain (n=36), and heartburn (n=38). The majority (58.6%) of patients reported improvement in their initial gastrointestinal symptoms-most commonly associated with initiation of a proton pump inhibitor. Upon follow-up, most patients reported a good quality of life and satisfaction with their current health status.

LE is a new clinical entity with an increasing incidence. LE seems to have a benign natural history, with most patients reporting an improvement in symptoms and satisfaction with their health-related quality of life. Prospective studies are needed to better characterize the natural history and potential treatments for this clinical entity.