Duodenal lymphocytosis in functional dyspepsia.
Adult
Aged
Aged, 80 and over
Biopsy
Case-Control Studies
Cross-Sectional Studies
Duodenal Diseases
/ complications
Dyspepsia
/ complications
Endoscopy, Gastrointestinal
Female
Helicobacter Infections
/ complications
Helicobacter pylori
Humans
Intestinal Mucosa
/ pathology
Lymphocytosis
/ complications
Male
Middle Aged
Bloating
Duodenal lymphocytosis
Functional dyspepsia
H. pylori
Microscopic duodenitis
Journal
Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology
ISSN: 2090-2387
Titre abrégé: Arab J Gastroenterol
Pays: Egypt
ID NLM: 101298363
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
08
01
2018
revised:
23
02
2019
accepted:
26
05
2019
pubmed:
9
6
2019
medline:
14
1
2020
entrez:
9
6
2019
Statut:
ppublish
Résumé
Functional dyspepsia is an exclusion diagnosis requiring different tests, including endoscopy, often repeated over time. Duodenal biopsies are frequently resorted to, not rarely revealing duodenal microscopic inflammation. Aim of the study is to confirm a previously supposed role of antro-duodenal low-grade inflammation in functional dyspepsia, evaluating the frequency of duodenal lymphocytosis, H. pylori infection and their association in a group of patients with functional dyspepsia compared to asymptomatic control subjects. A cross-sectional, observational study has been conducted screening all the patients who underwent duodenal biopsies during upper endoscopy, in a 30 months period. All the patients without endoscopic lesions were analysed. The study group consisted of patients compatible with the diagnosis of functional dyspepsia (Rome III criteria). The control group consisted of healthy asymptomatic subjects in the population subjected to endoscopy. The presence of duodenal lymphocytosis and of H. pylori infection in the two groups was evaluated. 216 patients were enrolled: 161 in the functional dyspepsia group and 55 as asymptomatic control group. The frequency of duodenal lymphocytosis was similar between cases and control groups (25.47% vs 25.45%; p = 0.99), as well as H. pylori infection (26.71% vs 23.64%; p = 0.78). Duodenal lymphocytosis was significantly associated with functional dyspepsia only in H. pylori positive dyspeptic patients (p = 0.047). 94% of the subjects with both lymphocytosis and H. pylori infection suffer from dyspepsia. Duodenal intraepithelial lymphocytosis is significantly associated with bloating (p = 0.0082). In our cohort of dyspeptic patients, duodenal lymphocytosis is significantly associated with bloating and the simultaneous presence of duodenal lymphocytosis and H. pylori infection is significantly more prevalent than in control subjects.
Sections du résumé
BACKGROUND AND STUDY AIMS
OBJECTIVE
Functional dyspepsia is an exclusion diagnosis requiring different tests, including endoscopy, often repeated over time. Duodenal biopsies are frequently resorted to, not rarely revealing duodenal microscopic inflammation. Aim of the study is to confirm a previously supposed role of antro-duodenal low-grade inflammation in functional dyspepsia, evaluating the frequency of duodenal lymphocytosis, H. pylori infection and their association in a group of patients with functional dyspepsia compared to asymptomatic control subjects.
PATIENTS AND METHODS
METHODS
A cross-sectional, observational study has been conducted screening all the patients who underwent duodenal biopsies during upper endoscopy, in a 30 months period. All the patients without endoscopic lesions were analysed. The study group consisted of patients compatible with the diagnosis of functional dyspepsia (Rome III criteria). The control group consisted of healthy asymptomatic subjects in the population subjected to endoscopy. The presence of duodenal lymphocytosis and of H. pylori infection in the two groups was evaluated.
RESULTS
RESULTS
216 patients were enrolled: 161 in the functional dyspepsia group and 55 as asymptomatic control group. The frequency of duodenal lymphocytosis was similar between cases and control groups (25.47% vs 25.45%; p = 0.99), as well as H. pylori infection (26.71% vs 23.64%; p = 0.78). Duodenal lymphocytosis was significantly associated with functional dyspepsia only in H. pylori positive dyspeptic patients (p = 0.047). 94% of the subjects with both lymphocytosis and H. pylori infection suffer from dyspepsia. Duodenal intraepithelial lymphocytosis is significantly associated with bloating (p = 0.0082).
CONCLUSIONS
CONCLUSIONS
In our cohort of dyspeptic patients, duodenal lymphocytosis is significantly associated with bloating and the simultaneous presence of duodenal lymphocytosis and H. pylori infection is significantly more prevalent than in control subjects.
Identifiants
pubmed: 31175076
pii: S1687-1979(19)30049-8
doi: 10.1016/j.ajg.2019.05.006
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
91-94Informations de copyright
Copyright © 2019 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.