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Helicobacter pylori gastritis in children: endoscopical and histological aspects
Radu Serban1, Paula Grigorescu-Sido, Dan Gheban
11st Pediatric Clinic, University of Medicine and Pharmacy, Str. Motilor no. 68, 3400 Cluj-Napoca, Romania.
Insights
Helicobacter pylori (Hp) infection in children often presents as antral nodular gastritis, confirmed by histology. Hp infection is linked to chronic gastritis, while uninfected children typically show acute gastritis.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Gastrointestinal Pathology
Background:
- Helicobacter pylori (Hp) infection is a significant factor in pediatric digestive and extradigestive diseases.
- Antral nodularity observed during endoscopy, resulting from mucosal lymphoid follicle development, is suggested as a specific indicator of gastritis in children.
- Histological identification of lymphoid follicles is considered pathognomonic for gastritis in pediatric cases.
Purpose of the Study:
- To determine the prevalence of gastritis in children.
- To investigate the correlation between endoscopic and histological findings in pediatric gastritis.
- To assess the diagnostic value of antral nodularity for Hp infection in children.
Main Methods:
- A study involving 267 children with digestive symptoms who underwent upper digestive endoscopy.
- Diagnosis of Hp infection was established by correlating positive urease test results with histological confirmation of Hp in gastric mucosa.
- Evaluation of endoscopic findings, including antral nodularity, and histological examination for gastritis patterns.
Main Results:
- Antral nodular gastritis, an endoscopic finding, was predominantly observed in children with Hp infection.
- Follicular gastritis, the histological correlate of nodular gastritis, was also present in cases of congestive gastritis.
- Patients with Hp infection most frequently exhibited chronic gastritis, whereas noninfected children typically presented with acute gastritis.
- Hp was consistently absent in gastric mucosa lacking histological changes.
Conclusions:
- The nodular pattern of antral mucosa may serve as a specific indicator of Hp infection in childhood.
- Hp infection in children is primarily associated with chronic gastritis, contrasting with acute gastritis in noninfected children.
- The absence of Hp in histologically normal gastric mucosa reinforces its role in gastritis development.
Unlabelled:
Helicobacter pylori (Hp) infection is involved in both digestive and extradigestive diseases. Endoscopically, antral location of gastritis, as well as antral nodularity, a consequence of the development of lymphoid follicles in the mucosa of this area, are considered by some authors specific for gastritis in children. Histologically, lymphoid follicles, noticed usually in children, are considered pathognomonic.
Aims:
To establish prevalence of gastritis in children and the correlation between of endoscopical and histological findings.
Patients And Methods:
The study group included 267 children in whom upper digestive endoscopy was performed for digestive symptoms. The diagnosis of Hp infection was based on the concordance between the positive urease test and the histological examination (documenting the presence of Hp in the gastric mucosa).
Results:
Endoscopical aspect of antral nodular gastritis was mainly found in children infected with Hp. Follicular gastritis, considered the histological marker of nodular gastritis, was also revealed in congestive gastritis. Patients infected with Hp most often displayed chronic gastritis and noninfected patients acute gastritis. Hp was not found in gastric mucosa without histological changes.
Conclusions:
Nodular pattern of antral mucosa might be considered specific for Hp infection in childhood. In patients infected with Hp chronic gastritis was mainly found while in noninfected children acute gastritis was usually revealed. Hp was not found in gastric mucosa without histological changes.
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