Lymphocytic gastritis is rare, characterized by >25 intraepithelial lymphocytes per 100 epithelial cells, specifically CD8+ T-cells. Prevalence has been reported as <0.3%. Little is known about the pathophysiology, however up to 80% may be found with Helicobacter pylori infections or celiac disease. Endoscopically, the gastric mucosa is classically described as nodular with hypertrophied rugae, with or without erosions and plaques. Lymphocytic gastritis is a histologic diagnosis and when encountered, clinical management is ill-defined. We sought to identify clinical characteristics of this disease. Patients with histological diagnosis of lymphocytic gastritis were identified from January 2007 to August 2019 at our tertiary-care, medical center. Each patient’s chart was reviewed. Demographic information, medical history and outcomes, medications, endoscopic findings, and pathologic results were recorded. Serologic tests for human immunodeficiency virus (HIV) were reviewed. Serologic or duodenal biopsies were used to screen for celiac disease. Twenty-six patients were identified with lymphocytic gastritis. Fifty percent were male and age ranged from 2 years to 77 years, averaging 49 years at time of upper endoscopy. Atopy (e.g. asthma, allergies, or eczema) was noted in 46% of patients. Five (19%) patients had history of autoimmune disorders. The most common indications for upper endoscopy included abdominal pain (30%) and anemia (23%). Fifteen percent of the patients had concomitant Helicobacter pylori infections based on gastric biopsies. Low proportions of patients were tested for celiac disease (50%) and HIV (26.9%); none were positive. Endoscopically, 75% had erythema and erosions and only 20% demonstrated the classically described nodular mucosa. Histologically, lymphocytic gastritis was commonly seen with chronic inflammation (65.4%). Among the 11 patients with duodenal biopsies, 36.4% had increased lymphocytes in the duodenum. Nearly half of the patients in our case series were noted to have atopy. Although lymphocytes are not typically associated with atopic illnesses, there are several studies elucidating the roles of CD4+ and CD8+ T cells in relation to eosinophils and mast cells in atopic dermatitis and asthma. Current management revolves around symptom control, however, further studies are needed to evaluate the implications of this pathological finding.Demographic information, clinical history, endoscopic findings, and pathologic results of patients diagnosed with lymphocytic gastritis.View Large Image Figure ViewerDownload Hi-res image Download (PPT)