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Omeprazole-associated changes in the gastric mucosa of children

R Drut1, E Altamirano, E Cueto Rúa

  • 1Department of Pathology, Superiora Sor María Ludovica Children's Hospital, La Plata, Argentina. patologi@netverk.com.ar

Journal of Clinical Pathology
|December 14, 2007
PubMed

Insights

Proton-pump inhibitors (PPIs) cause rapid histological changes in children's gastric mucosa, including parietal cell alterations and increased nuclei. These findings, similar to adults, suggest a combined effect of PPIs and gastrin release.

Area of Science:

  • Pediatric Gastroenterology
  • Histopathology
  • Pharmacology

Background:

  • Proton-pump inhibitors (PPIs) are widely used in children.
  • Long-term effects of PPIs on pediatric gastric mucosa are not fully understood.
  • Histological changes in adults treated with PPIs have been documented.

Purpose of the Study:

  • To investigate histological alterations in the gastric mucosa of children receiving PPI therapy.
  • To compare findings in children with controls.
  • To assess the impact of PPI treatment duration on gastric histology.

Main Methods:

  • Gastric biopsy specimens from 12 children (8 months–15 years) on PPIs and 8 controls were analyzed.
  • Histological examination included Hematoxylin and Eosin (H&E) staining.
  • Immunohistochemistry for sialyl-Tn antigen was performed.

Main Results:

  • Parietal cells exhibited eosinophilia, cytoplasmic protrusions, hypertrophy, and increased nuclear count (binucleation/multinucleation).
  • Sialyl-Tn antigen showed a strong reaction on intracellular canaliculi, potentially marking this structure.
  • Observed changes occurred rapidly, even after short-term PPI administration.

Conclusions:

  • PPIs induce histological changes in pediatric gastric mucosa, mirroring adult findings but with increased nuclear numbers.
  • These PPI-induced effects are novel in the pediatric age group.
  • The observed changes are likely due to a combination of PPI effects and gastrin release.
Abstract

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