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Lymphocytic esophagitis in children.

Lisa M Sutton1, D Dyer Heintz, Ashish S Patel

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Lymphocytic esophagitis (LE) is more common in children and significantly associated with Crohn's disease (CD). This study reviewed pediatric esophageal biopsies to confirm LE prevalence and clinical links in children.

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Area of Science:

  • Gastroenterology
  • Pediatric Pathology
  • Immunology

Background:

  • Lymphocytic esophagitis (LE) is defined by increased intraepithelial lymphocytes in esophageal biopsies.
  • Previous studies suggest a link between LE and Crohn's disease (CD) in pediatric patients.
  • A comprehensive review of a large pediatric cohort is needed to establish LE prevalence and associations.

Purpose of the Study:

  • To determine the prevalence of lymphocytic esophagitis (LE) in a pediatric cohort.
  • To investigate the clinical associations of LE in children, particularly its relationship with Crohn's disease (CD).

Main Methods:

  • A retrospective review of all esophageal biopsies from a tertiary care pediatric center over one year.
  • Blinded histologic assessment to identify LE cases based on lymphocyte counts.
  • Independent clinical data review by a pediatric gastroenterologist for identified LE cases.

Main Results:

  • Lymphocytic esophagitis (LE) was identified in 5.7% of pediatric patients.
  • A significant association was found between LE and Crohn's disease (CD) (19% of LE patients had CD).
  • LE was more prevalent in patients with CD (12.2%) compared to those without CD (5.0%).

Conclusions:

  • Lymphocytic esophagitis (LE) appears more prevalent in children than adults.
  • LE shows a significant association with Crohn's disease (CD) in the pediatric population.
  • Further research may elucidate the specific mechanisms underlying the LE-CD association in children.