Helicobacter pylori infection in children with celiac disease
Sema Aydogdu1, Murat Cakir, Hasan Ali Yuksekkaya
1Department of Pediatric Gastroenterology Hepatology and Nutrition, Ege University, Izmir, Turkey.
Insights
Helicobacter pylori (H. pylori) gastritis is common in children with celiac disease (CD) and is linked to mild duodenal lesions. A gluten-free diet effectively manages CD symptoms, regardless of H. pylori infection status.
Area of Science:
- Gastroenterology
- Pediatric Medicine
- Infectious Diseases
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- The interplay between CD and Helicobacter pylori (H. pylori) infection in pediatric populations requires further elucidation.
- Understanding coinfection prevalence and impact is crucial for comprehensive patient management.
Purpose of the Study:
- To determine the prevalence of H. pylori infection in children diagnosed with celiac disease.
- To investigate the association between H. pylori infection and the clinical, laboratory, and histopathological features of pediatric celiac disease.
- To assess the influence of H. pylori on gastric metaplasia and duodenal histology in CD patients.
Main Methods:
- A comparative study involving 96 children with CD and 235 children undergoing endoscopy.
- Analysis of H. pylori prevalence and gastric histology patterns in both groups.
- Comparison of clinical presentation, laboratory results, and histological findings between CD patients with and without H. pylori infection.
Main Results:
- H. pylori gastritis was observed in 21.8% of CD patients and 23.8% of controls.
- Gastric metaplasia was significantly higher in CD patients with H. pylori (19%) compared to those without (1.3%) and controls (3.5%).
- Abdominal distension was more frequent in CD patients with H. pylori (57.1%) than without (14.6%). Mild duodenal histological findings were also more common in H. pylori-positive CD patients (57.1%).
Conclusions:
- Celiac disease may be associated with H. pylori gastritis, which is linked to increased gastric metaplasia and mild duodenal lesions.
- H. pylori infection does not significantly alter most clinical or laboratory presentations of CD, except for increased abdominal distension.
- A gluten-free diet provides symptomatic relief for all CD patients, irrespective of H. pylori status, highlighting its primary therapeutic role.
Objective:
To analyze the prevalence of Helicobacter pylori (H. pylori) infection in children with celiac disease (CD) and to examine the role of H. pylori infection in clinical, laboratory and histopathological presentations of CD.
Material And Methods:
Data on 96 children with CD and 235 children who underwent endoscopy were compared for the prevalence and gastric histology pattern of H. pylori. Clinical presentation, laboratory and histological findings of CD children with and without H. pylori infection were compared.
Results:
Twenty-one subjects (21.8%) in the CD group and 56 subjects (23.8%) in the control group had H. pylori gastritis. Gastric metaplasia is higher in CD patients with H. pylori gastritis (19%) than in patients without H. pylori gastritis (1.3%) and in the control group (3.5%) (p<0.05 for all groups). Abdominal distension is more common at initial admission in CD patients with H. pylori gastritis (57.1% versus 14.6%, p<0.05). No significant difference was found between H. pylori (+) and (-) CD patients in terms of prevalence of anemia, iron deficiency and iron-deficiency anemia. Only mild duodenal histological findings were more common in H. pylori patients (57.1% versus 26.7%, p<0.05).
Conclusions:
CD may be associated with H. pylori gastritis, but it does not affect the clinical presentation of the disease, except for abdominal distension; CD is associated with mild duodenal lesions. A gluten-free diet improves the symptoms in all patients independently of the presence of H. pylori gastritis. Gastric metaplasia increases in the presence of H. pylori gastritis. Further prospective studies are needed to examine the clinical and histopathological outcomes of gastric metaplasia associated with H. pylori gastritis in CD patients.
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