Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2016; 4(12): 413-418
Published online Dec 16, 2016. doi: 10.12998/wjcc.v4.i12.413
Lymphocytic esophagitis: Report of three cases and review of the literature
Bilel Jideh, Andrew Keegan, Martin Weltman
Bilel Jideh, Andrew Keegan, Martin Weltman, Department of Gastroenterology and Hepatology, Nepean Hospital, New South Wales, Sydney 2747, Australia
Author contributions: Weltman M designed the report, was the attending gastroenterologist of one of the clinical cases, and edited the draft manuscript; Keegan A was the attending gastroenterologist of two of the clinical cases and edited the draft manuscript; Jideh B reviewed the literature and wrote the paper.
Institutional review board statement: Nepean Hospital institutional review board gave consent for anonymous description of the clinical case series presented.
Informed consent statement: The three patients described in the case reports gave verbal consent for anonymous description of their case.
Conflict-of-interest statement: None of the authors have any conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bilel Jideh, Gastroenterology Trainee, Department of Gastroenterology and Hepatology, Nepean Hospital, Derby Street, Kingswood, New South Wales, Sydney 2747, Australia. bjid7747@uni.sydney.edu.au
Telephone: +61-413-724433 Fax: +61-247-341313
Received: April 10, 2016
Peer-review started: April 12, 2016
First decision: May 19, 2016
Revised: September 7, 2016
Accepted: September 21, 2016
Article in press: September 22, 2016
Published online: December 16, 2016
Processing time: 240 Days and 13.2 Hours
Abstract

Lymphocytic esophagitis (LyE) is a rare condition characterised histologically by high numbers of esophageal intraepithelial lymphocytes without significant granulocytes infiltration, in addition to intercellular edema (“spongiosis”). The clinical significance and natural history of LyE is poorly defined although dysphagia is reportedly the most common symptom. Endoscopic features range from normal appearing esophageal mucosa to features similar to those seen in eosinophilic esophagitis, including esophageal rings, linear furrows, whitish exudates, and esophageal strictures/stenosis. Symptomatic gastroesophageal reflux disease is an inconsistent association. LyE has been associated in paediatric Crohn’s disease, and recently in primary esophageal dysmotility disorder in adults. There are no studies assessing effective treatment strategies for LyE; empirical therapies have included use of proton pump inhibitor and corticosteroids. Esophageal dilatation have been used to manage esophageal strictures. LyE has been reported to run a benign course; however there has been a case of esophageal perforation associated with LyE. Here, we describe the clinical, endoscopic and histopathological features of three patients with lymphocytic esophagitis along with a review of the current literature.

Keywords: Esophagitis; Lymphocytes; Gastroesophageal reflux disease; Eosinophilic esophagitis; Esophageal dysmotility

Core tip: Lymphocytic esophagitis (LyE) is a histological subset of esophagitis that is rare with poorly defined clinical significance and associations. We present the clinical, endoscopic and histopathological features of three patients with LyE followed by the most up-to-date literature on the condition, including description of the newly postulated association of primary esophageal dysmotility.