Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2012
Lymphocytic duodenosis: aetiology and long-term response to specific treatment.
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Rosinach Mercé, Esteve Maria, González Clarisa, Temiño Rocio, Mariné Meritxell, Monzón Helena, Sainz Empar, Loras Carme, Espinós Jorge C, Forné Montse, Viver Josep M, Salas Antonio, Fernández-Bañares Fernando
Аннотация
BACKGROUND: The clinical significance of lymphocytic duodenosis remains unclear.
AIM: To prospectively assess the aetiology of lymphocytic duodenosis and the patterns of clinical presentation.
METHODS: Ninety consecutive patients with lymphocytic duodenosis and clinical symptoms of the coeliac disease spectrum were prospectively included. All subjects underwent serological testing and HLA genotyping for coeliac disease, assessment of Helicobacter pylori infection, and parasite stool examination. Intake of non-steroidal anti-inflammatory drugs was also recorded. The final aetiology of lymphocytic duodenosis was evaluated on the basis of the long-term response to specific therapy.
RESULTS: More than one initial potential aetiology was observed in 44% of patients. The final diagnosis was gluten-sensitive enteropathy alone or associated with Helicobacter pylori infection in 43.3%, Helicobacter pylori infection (without gluten-sensitive enteropathy) in 24.4%, non-steroidal anti-inflammatory drugs intake in 5.5%, autoimmune disease in 3.3%, and parasitic infection in 2.2%. Among first degree relatives and patients with chronic diarrhoea, the most common final diagnosis was gluten-sensitive enteropathy. In contrast, in the group presenting with chronic dyspepsia the most common diagnosis was Helicobacter pylori infection ('Diarrhoea' vs 'Dyspepsia' groups, p=0.008).
CONCLUSIONS: Lymphocytic duodenosis is often associated with more than one potential initial aetiology. Clinical presentation may be useful to decide the initial therapeutic approach with these patients.
AIM: To prospectively assess the aetiology of lymphocytic duodenosis and the patterns of clinical presentation.
METHODS: Ninety consecutive patients with lymphocytic duodenosis and clinical symptoms of the coeliac disease spectrum were prospectively included. All subjects underwent serological testing and HLA genotyping for coeliac disease, assessment of Helicobacter pylori infection, and parasite stool examination. Intake of non-steroidal anti-inflammatory drugs was also recorded. The final aetiology of lymphocytic duodenosis was evaluated on the basis of the long-term response to specific therapy.
RESULTS: More than one initial potential aetiology was observed in 44% of patients. The final diagnosis was gluten-sensitive enteropathy alone or associated with Helicobacter pylori infection in 43.3%, Helicobacter pylori infection (without gluten-sensitive enteropathy) in 24.4%, non-steroidal anti-inflammatory drugs intake in 5.5%, autoimmune disease in 3.3%, and parasitic infection in 2.2%. Among first degree relatives and patients with chronic diarrhoea, the most common final diagnosis was gluten-sensitive enteropathy. In contrast, in the group presenting with chronic dyspepsia the most common diagnosis was Helicobacter pylori infection ('Diarrhoea' vs 'Dyspepsia' groups, p=0.008).
CONCLUSIONS: Lymphocytic duodenosis is often associated with more than one potential initial aetiology. Clinical presentation may be useful to decide the initial therapeutic approach with these patients.
Предметные рубрики MeSH
AdultAnti-Inflammatory Agents, Non-SteroidalAutoimmune DiseasesBlastocystis InfectionsCD3 ComplexCeliac DiseaseDuodenal DiseasesFemaleGTP-Binding ProteinsGenotypeHLA-DQ AntigensHelicobacter InfectionsHelicobacter pyloriHumansLymphocyte CountLymphocytesMaleMiddle AgedProspective StudiesProtein Glutamine gamma Glutamyltransferase 2Transglutaminases