P3918 - Comparison of Symptomatology, Risk Factors, and Endoscopic Findings Between Lymphocytic Esophagitis (LyE) and Eosinophilic Esophagitis (EoE): A Retrospective Cross-Sectional Study

Dhruvkumar Patel, MBBS¹, Maitri M. Patel, MBBS², Mukundkumar Patel, MD³, Dhara Patel, MD², Lalitkumar Patel, MD⁴, Hassaan A. Zia, MD^5
1LSU Health Science Center, Shreveport, LA; ²GCS Medical College and Research Centre, Ahmedabad, Gujarat, India; ³Ananya College of Medicine and Research, Ahmedabad, Gujarat, India; ⁴Narendra Modi Medical College, Ahmedabad, Gujarat, India; ⁵LSU Health, Shreveport, LA

Introduction: Lymphocytic esophagitis (LyE) and eosinophilic esophagitis (EoE) share significant clinical and endoscopic features, with LyE being the least recognized form of esophagitis. This retrospective analysis compares symptomatology, risk factors, and endoscopic findings between LyE and EoE.

Methods: We retrospectively reviewed medical records, EGD findings, and histopathology data from March 2018 to January 2024. The study included adults with gastrointestinal symptoms who underwent EGD with biopsies. Patients without written consent and those with insufficient records were excluded. Data collected included symptoms, diagnoses, endoscopic, and histopathological findings.

Diagnostic criteria for LyE included >20 lymphocytes with intracellular edema and minimal/no granulocytes per high-power field (HPF). EoE was diagnosed with >20 eosinophils per HPF. Features not meeting the criteria for LyE or EoE were classified as nonspecific esophagitis. Descriptive and comparative analyses were performed using SPSS.

Results: Among 1260 patients, LyE was observed in 0.87%, EoE in 6.26%, and nonspecific esophagitis in 35.47%. Normal esophageal histology was found in 27.38%.


The mean age of LyE patients was 54.81 years, compared to 43.52 years for EoE. Females predominated in LyE (72.72%), whereas males were more prevalent in EoE (67%). LyE was significantly associated with smoking/tobacco use. Food impaction was more common in EoE, while regurgitation in LyE. Other symptoms did not differ significantly. Hypothyroidism was more prevalent in LyE, whereas bronchial asthma, and diabetes in EoE. Esophagitis and strictures were more common in LyE, rings, and exudates in EoE. Normal mucosal findings were more common in LyE than in EoE.

Discussion: The prevalence of LyE in our study was higher than previously reported, while the incidence of EoE matched reported rates. LyE was more prevalent among females and affected an older age group, whereas EoE was more common in males and a younger demographic. Both conditions showed substantial symptom overlap, but food impaction was more prevalent in EoE and regurgitation in LyE. Hypothyroidism was a risk factor for LyE, while bronchial asthma and diabetes were associated with EoE.

Endoscopic patterns differed, with exudates and rings more common in EoE, and strictures and esophagitis more common in LyE. A significant proportion of LyE cases had normal endoscopic appearances, highlighting the importance of histological examination for accurate diagnosis.


Disclosures:


Dhruvkumar Patel, MBBS¹, Maitri M. Patel, MBBS², Mukundkumar Patel, MD³, Dhara Patel, MD², Lalitkumar Patel, MD⁴, Hassaan A. Zia, MD⁵. P3918 - Comparison of Symptomatology, Risk Factors, and Endoscopic Findings Between Lymphocytic Esophagitis (LyE) and Eosinophilic Esophagitis (EoE): A Retrospective Cross-Sectional Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.