The Clinical Significance of Focally Enhanced Gastritis in Children

Focally enhanced gastritis (FEG) was initially described in patients with inflammatory bowel disease (IBD), but subsequent reports found this to be a nonspecific finding in adults. Initial reports suggest that FEG may be more predictive of IBD in pediatric patients, but this has yet to be confirmed. The aim of our study was to characterize and determine clinical correlates of FEG in pediatric patients. Gastric biopsies from pediatric patients who were diagnosed with FEG at a single tertiary care center over a 5-year period were reviewed (5-y cohort study). In a subsequent study, all gastric biopsies from pediatric patients in the single center over a 1-year period were reviewed. Biopsies were reviewed in a blinded manner by 2 pathologists, and histologic data of interest were recorded. Clinical data and follow-up data were recorded from review of the electronic medical records. Of the 25 patients with FEG in the 5-year cohort study, IBD was present in 19 (76%) patients. Crohn disease (CD) was more common than ulcerative colitis (UC) among these patients (68% vs. 16%). In the 1-year review study with 262 gastric biopsies, FEG was present in 31 (11%) cases. Patients with FEG were significantly more likely to have IBD than non-FEG patients (61.3% vs. 11.6%, P <= 0.001). Of the 19 patients with FEG and IBD, 9 patients had CD, 9 patients had UC, and 1 had indeterminate colitis. The presence of FEG is highly associated with IBD in pediatric patients. The presence of FEG does not reliably distinguish between patients with CD and those with UC.