Related Experiment Videos
Helicobacter pylori infection in children: clinical, endoscopic, and histologic correlations
G Prieto1, I Polanco, J Larrauri
1Department of Paediatrics, La Paz Children's Hospital, Madrid, Spain.
Insights
Helicobacter pylori (HP) infection is common in children with abdominal pain, increasing with age. This study suggests HP plays a key role in pediatric gastroduodenal diseases.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Pathology
Background:
- Abdominal pain is a common complaint in children.
- Helicobacter pylori (HP) is a known pathogen in gastroduodenal diseases.
- The role of HP in pediatric populations requires further elucidation.
Purpose of the Study:
- To investigate the prevalence and clinical significance of Helicobacter pylori (HP) in children presenting with abdominal pain.
- To correlate HP infection with endoscopic and histopathological findings in pediatric gastroduodenal disease.
Main Methods:
- Endoscopic evaluation of 270 children (0.8-20 years) with abdominal pain.
- HP detection via bacterial culture.
- Histopathological analysis of gastric biopsies, including semiquantitative assessment of HP colonization.
Main Results:
- HP was detected in 33.7% of patients, with prevalence increasing significantly with age.
- HP positivity was strongly associated with diagnoses of gastritis and peptic ulcers (gastric and duodenal).
- Endoscopic nodular antritis and histological signs of activity were frequent in HP-positive children, correlating with bacterial load.
Conclusions:
- Helicobacter pylori (HP) is a significant factor in pediatric gastroduodenal pathology.
- HP infection is associated with specific endoscopic and histopathological findings in children.
- The study supports a pathogenic role for HP in the development of gastroduodenal disease in pediatric patients.
Abstract:
We have assessed 270 consecutive patients (age range 0.8-20 years) referred for endoscopic study because of abdominal pain during 32 months. Helicobacter pylori (HP) was detected by culture in 91 cases (33.7%). HP colonization increased significantly with age (p less than 0.01). Nine patients less than 5 years of age were colonized by HP. A previous history of peptic ulcer disease in first-degree relatives was significantly more frequent in the HP-positive group (p less than 0.001). The frequency of HP positiveness as related to diagnosis was: normal, 3.3%; nonactive chronic gastritis, 100%; active chronic gastritis, 97.2%; gastric ulcer, 75%; and duodenal ulcer, 90.9% (p less than 0.001). Endoscopic nodular antritis was a frequent (67%) and specific finding; this presence was associated with that of lymphoid follicles in the histopathological study. Signs of histological activity were observed in 55.9% of the HP-positive patients. The histological colonization by HP was assessed semiquantitatively, and a significantly greater HP colonization score was observed in patients with signs of histological activity (p less than 0.001). A significant correlation was found between HP colonization score and histological score (rs = 0.574), with a significant association between the degree of HP colonization and the histologic categories (p less than 0.001). The present study suggests a pathogenic role of HP in the development of gastroduodenal disease in children.