Other gastritis and gastropathy

Other gastritis and gastropathy 

Updated: 02/17/2021

© Jun Wang, MD, PhD

Eosinophilic gastritis

• Usually children or young adults
• History of allergy
• Commonly involve other GI locations
• Diffuse eosinophilic infiltrate
• Treatment: steroids, diet modification, etc

Lymphocytic gastritis

• Uncommon
• More common in elder patients
• Increased intraepithelial lymphocytes, and lymphoplasma cell infiltrate in lamina propria
  
• Usually CD8+ T cells
• Associated with celiac disease, H. Pylori infection, Ménétrier’s disease, lymphocytic or collagenous colitis, etc
• Treatment: focus on underlying etiology

Granulomatous gastritis:

• Associated with infection, foreign bodies, sarcoidosis, common variable immunodeficiency, Crohn’s disease, etc;
• Diagnosis of exclusion

Menetrier’s disease

• AKA hyperplastic gastropathy 
• Commonly involving fundus and body
• More common in men, mean age 30-50
• Low acid production
• Excessive TGF-alpha and EGFR signaling
• Usually great curvature with marked foveolar hyperplasia
• Likely self-limited in children 
• Medical treatment: Proton pump inhibitor, monoclonal EGFR antibodies, etc
  
• Surgery for patients with symptoms and signs refractory to medical management
  

Zollinger-Ellison syndrome

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