P1817 - Lymphocytic Esophagitis Is Increasing in Incidence

Kyle Yuquimpo, DO¹, Charlie Altfillisch, MD¹, Rachel Stetson, BS², Grace Howell, BS³, Andrea Decino, MD¹, Fortune Unegbu, MD¹, Falak Hamo, MD¹, Dhruvil Radadiya, MBBS¹, Ameer Hamza, MD¹, Salih Samo, MD, MSc^1
1University of Kansas Medical Center, Kansas City, KS; ²University of Kansas School of Medicine, Kansas City, KS; ³Kansas City University, Kansas City, MO

Introduction: Lymphocytic esophagitis (LyE) is a rare inflammatory esophageal disease associated with variable esophageal symptoms. The prevalence or incidence of LyE in the United States is not well known. The aim of this study was to assess for the incidence of LyE on esophageal biopsies over time.

Methods: Esophageal biopsies obtained from January 2019 to August 2022 were reviewed. Patient demographics, clinical indication, history of autoimmune disease or inflammatory bowel disease (IBD), histological diagnosis were collected. The diagnosis of LyE was considered when it was either described as the primary pathologic diagnosis or listed as a differential diagnosis. Patients with concomitant candidiasis, eosinophilic esophagitis, or achalasia were excluded. Incidence rate was calculated and normalized per 100 cases reviewed for 2 periods: 1) from January 2019 to August 2020, and 2) from September 2020 to August 2022 (an esophagologist who asks for assessment of LyE on all esophageal biopsies joined the practice during the second period).

Results: A total of 3177 esophageal biopsies were reviewed. Overall, 39 cases of LyE were found: 13 before September 2020 and 26 after (Table 1). More than 75% of these patients were female and >50 years old and the incidence rate of LyE gradually increased from 2019 to 2022 (Figure 1). Prompting to rule out LyE occurred in 25% of cases after September 2020. Five patients were reported to have LyE after September 2020 with previous biopsies reported as negative for LyE.

Discussion: The incidence rate of LyE on esophageal biopsied appears to be rising. Our data suggest that the incidence may be higher if LyE evaluation is specifically requested when obtaining esophageal biopsies. LyE appears to have a high association with autoimmune/IBD disease.



Disclosures:


Kyle Yuquimpo, DO¹, Charlie Altfillisch, MD¹, Rachel Stetson, BS², Grace Howell, BS³, Andrea Decino, MD¹, Fortune Unegbu, MD¹, Falak Hamo, MD¹, Dhruvil Radadiya, MBBS¹, Ameer Hamza, MD¹, Salih Samo, MD, MSc¹. P1817 - Lymphocytic Esophagitis Is Increasing in Incidence, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.