Symptomatology of Helicobacter pylori Related Chronic Gastritis
and its Specific Features in Czech Pediatric Population –Epidemiology, Clinical Course, Endoscopic and Histomorphologic
Changes
Sýkora J., Varvařovská J., 1Kuntschnerová J., Stožický F. , 2Vincent P., 3Martin-de Lasalle E., 4Gottrand F.
Dětská klinika FN a LF UK, Plzeň 1Šiklův patologicko-anatomický ústav FN a LF UK, Plzeň 2Laboratoire de Bactériologie, Faculté de Médicine, Lille, Francie 3Service d’Anatomie et cytologie Pathologique, Faculté de Médicine, Lille, Francie 4Unité de Gastro-entérologie, Hépatologie et Nutrition, Clinique de Pédiatrie, Hopital Jeanne de Fkandre, 59037 Lille, Francie |
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Summary:
Background. H. pylori infection is associated with gastritis and peptic ulcer in children and adults. H. pylori
acquisition seems to occur predominantly in childhood. Some data have reported H. pylori non-related chronic
gastritis. Little information is available about the relationship between H. pylori, clinicopathologic features and
long-termeffects of infection in childhood. The purpose of this study was to compare the differences between chronic
gastritis due to H. pylori with those of chronic gastritis not associated with H. pylori infection.
Methods and Results. 92 children (13,8±3,5 years) were take into they shaded group. 51 children were H. pylori
positive, 41 children had no evidence of H. pylori. Epidemiological and clinical data, endoscopic appearance and
histologic examination were evaluated. There were no differences in age and gender among the children. There was
a significant correlation between H. pylori infection and parental education (p<0.05) and habitat crowding (the
number of rooms). There were no differences in clinical diagnosis and occurrence of any predominant symptom
between the two groups. There was an association with a detrimental influence on daily life and activities
in H. pylori patients (p<0.01). Extradigestive symptoms (chronic urticaria, sideropenic anemia) were significantly
more common in the H. pylori positive group (p<0.05). 21 children (41.6 %) were H. pylori positive/cagA positive,
15 of them (30.3 %) were H. pylori positive/vacA positive. Findings of antral nodularity were more frequent in H.
pylori positive children than in H. pylori negative (p<0.000001). There were no differences in erythematous gastritis,
haemorrhage and mucosal ulceration. H. pylori density score did not differ in various part of the gastric mucosa
(antrum, corpus). Chronic gastritis was found to be more severe in patients with H. pylori infection compared with
H. pylori-negative gastritis. Statistically significant was the increased presence of neutrophils, edema, monocytes,
lymphoid follicles, the intensity of inflammation and mucosal oedema in the gastric mucosa in H. pylori positive
children. There were no differences in the incidence of foveolar hyperplasia, mucosal atrophy, intestinal metaplasia
and erosion. Conclusion. H. pylori related chronic gastritis may be considered as a specific form of inflammation and it may
be associated with a typical clinical symptomatology in a subgroup of children in Czech population. Precautions in
life style may diminish H. pylori – related disease in children.
Key words:
chronic gastritis, H. pylori, epidemiology, clinical symptomatology, endoscopy, histology, sideropenic
anaemia, chronic urtica, childhood.
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