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Long-term aspects of nodular gastritis in children
Mustafa Akcam1, Reha Artan, Tekinalp Gelen
1Medical School, Akdenz University, Antalya, Turkey. makcam@akdeniz.edu.tr
Insights
Long-term follow-up of childhood nodular gastritis shows persistent antral nodularity in most cases, often linked to Helicobacter pylori re-infection. New treatments are needed for endemic areas.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Gastrointestinal Pathology
Background:
- Nodular gastritis is closely associated with Helicobacter pylori infection.
- Short-term recovery after H. pylori eradication is documented, but long-term outcomes remain unclear.
- This study investigates the long-term clinical, endoscopic, and histologic status of childhood nodular gastritis.
Purpose of the Study:
- To assess the long-term clinical condition of children with nodular gastritis.
- To determine the persistence of H. pylori infection and antral nodularity.
- To evaluate endoscopic and histologic changes over time.
Main Methods:
- 35 children with endoscopically diagnosed antral nodularity were followed for 3 years.
- H. pylori-positive patients received standard triple eradication therapy.
- Repeated endoscopy and biopsy were performed on 27 patients for re-evaluation.
Main Results:
- Antral nodularity persisted in 18 of 27 patients (67%).
- H. pylori infection was present in 16 patients (89%) at follow-up.
- No significant changes were observed in biopsy activity, atrophy, intestinal metaplasia, or follicle presence. No MALT lymphoma was detected.
Conclusions:
- Persistent antral nodularity in nodular gastritis may be linked to H. pylori re-infection.
- The strong association between nodular gastritis and H. pylori necessitates further investigation.
- Novel therapeutic strategies are required for managing nodular gastritis in H. pylori-endemic regions.
Background:
Close association of nodular gastritis and Helicobacter pylori infection has been initially proved by various studies. There have been some studies reporting microscopic and histologic recovery in a short time after eradication therapy. But there is not enough data about the long-term course of this condition. The aim of this study is to document current clinical conditions, presence of H. pylori and results of endoscopic and histologic examination, after a long-term period, in children with endoscopically diagnosed antral nodularity.
Methods:
A total of 35 patients diagnosed as nodular antral gastritis by upper gastrointestinal endoscopy during a 2 year period, were invited for re-evaluation and re-endoscopy after 3 years. Histopathologically, H. pylori detected ones had been treated with standard triple eradication therapy. In total, 27 patients were accepted for enrollment in the study. Repeated endoscopy could be performed in all 27 patients.
Results:
The persistence of antral nodularity was detected in 18 of 27 patients. Decrease in symptoms, absence of symptoms and presence of H. pylori infection were detected in 6, 8 and 16 (89%) of them, respectively. There was no statistical significance between the first and last endoscopic biopsies when activity, atrophy, intestinal metaplasia and presence of follicles were regarded. Malt lymphoma could not be detected in any of the patients.
Conclusion:
There is a strong association between nodular gastritis and H. pylori. Presence of antral nodularity in the long-term period may be related to H. pylori re-infection. New therapeutic approaches are required for treatment and management of the patients diagnosed as nodular gastritis and living in areas endemic for H. pylori infection.
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