Age-related differences in granulomatous gastritis: a retrospective, clinicopathological analysis

Abstract

BackgroundGranulomatous gastritis (GG) is an uncommon pathological finding that may accompany systemic disease, infections, foreign body reaction, malignancy or vasculitis, but may also be an isolated finding. Clinical and pathological features of GG have been systematically evaluated in adults but not children.ObjectivesTo compare clinical and pathological features of GG in adults and children, and also determine the prevalence of GG in children from a single centre.MethodsA retrospective analysis of 23 children and 23 adults with GG was conducted. Demographic and clinical information was recorded for each patient. Gastric biopsy specimens were evaluated for the presence of gastritis, infectious organisms, and number and location of the granulomas.ResultsChildren were a mean±SD age of 12.5±3.0 years, had a male predominance, and were most often Caucasian. Adults were a mean±SD age of 49.2±13.2 years, had a female predominance, and were most often African–American. Primary diagnoses were Crohn's disease in children, and sarcoidosis and isolated GG in adults. In both groups, granulomas were most often located in the antrum, with no difference in the number of granulomas per biopsy between children and adults. All biopsy specimens were negative for acid-fast bacilli and fungal organisms; Helicobacter pylori infection was uncommon. Overall prevalence of GG in children in this study was 1.7% for all diagnostic upper endoscopies.ConclusionDifferences in aetiology of GG between children and adults reflect age-specific disease states. Gender differences can be partially explained by gender differences intrinsic to the underlying aetiology. Irrespective of the underlying aetiology, the number and location of granulomas are similar in children and adults.