Lymphocytic gastritis--relationship to Campylobacter pylori infection

The existence of a distinctive form of chronic gastritis characterized by marked infiltration of the surface and pitlining epithelium by mature T lymphocytes has been confirmed. Seventeen cases were identified amongst 382 patients with active chronic gastritis (4.5 per cent). The cases with lymphocytic gastritis had significantly higher counts of intraepithelial lymphocytes than sex and age-matched controls drawn from a series of patients with the usual form of active Type B chronic gastritis. Furthermore, the lymphocytic gastritis group exhibited unusual endoscopic findings, namely erosions and 'raised lesions', in the body of the stomach. Such appearances have been previously described as 'varioliform' gastritis. Only seven of the patients (41 per cent) had C. pylori-positive biopsies, compared with over 90 per cent in the generality of active chronic gastritis, but all but two of the eleven cases tested had serological evidence of C. pylori infection. While the pathogenesis of this condition is unclear, the histological resemblance to coeliac disease suggests that lymphocytic gastritis might also represent an abnormal response to a local antigen to which the patient has become sensitized. It is possible that this antigen is C. pylori.