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Lymphocytic Esophagitis
A Chronic or Recurring Pattern of Esophagitis Resembling Allergic Contact Dermatitis

Julianne K. Purdy MD, Henry D. Appelman MD, Christopher P. Golembeski MD, Barbara J. McKenna MD
DOI: http://dx.doi.org/10.1309/D3PCF6D6YYMQRX9A 508-513 First published online: 1 October 2008

Abstract

Lymphocytic esophagitis (LE) is characterized by intraepithelial lymphocytes (IELs) and spongiosis, resembling contact dermatitis. LE has been defined as high numbers of IELs and no or rare granulocytes and was found in young patients and in association with Crohn disease (CD). We reviewed the medical records of 42 LE cases. Cases were divided into severe (IELs in interpapillary and peripapillary fields) and mild (IELs in peripapillary fields) LE. The control group included specimens from 34 consecutive esophageal biopsy cases. Mean ages were similar (LE, 44 years; control subjects, 43 years). CD was present in 5 LE cases (12%) and 1 control case, an insignificant difference. Of patients with LE, 14 (33%) had an allergy; 11 (26%), gastroesophageal reflux disease (GERD); 4 (10%), Helicobacter pylori gastritis; and 18 (43%), dysphagia. No differences were found in clinical features between LE and control cases, except GERD was less common in severe LE (6/30 [20%]) than in control cases (17 [50%]). No patient with LE had celiac disease. No medications were common among LE cases. Patients with LE are statistically no more likely than control subjects to have CD. We found no association between LE and any clinical condition or symptom. Based on sequential biopsies in 7 patients, LE seems to be a chronic disease.

Key Words:
  • Lymphocytosis
  • Esophagitis
  • Spongiosis
  • Crohn disease
  • Allergy