Lymphocytic gastritis in a child with hemophagocytic syndrome

Lymphocytic gastritis (LG) is an unusual form of chronic gastritis first described a decade ago in adult patients. The characteristic feature of LG is the surface intraepithelial T-cell lymphocytic infiltration, with relatively few lymphocytes in the lamina propria. Endoscopically, LG often correlates with the features of so-called “varioliform gastritis.” LG has seldom been reported in children, and then usually in association with celiac disease. We describe a case of LG in a 2-year-old child who died of a hepatitis A virus-induced hemophagocytic syndrome (HPS). LG was diagnosed retrospectively at the postmortem examination. The stomach showed diffuse thickening of mucosal folds with small erosions. On microscopic examination prominent intraepithelial infiltration of the gastric mucosa by T-cells was found, but the small bowel showed no villous atrophy, excluding the diagnosis of celiac disease. To the best of our knowledge, this is the first description of a case of LG associated with an infection-related HPS.