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Helicobacter pylori in children with peptic ulcer and their families
Insights
Helicobacter pylori (H. pylori) infection is common in children with peptic ulcers and frequently found in their family members, suggesting person-to-person transmission. This study confirms H. pylori screening reliability and highlights its role in childhood peptic ulcer disease.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pediatrics
Background:
- The transmission routes of Helicobacter pylori (H. pylori) remain unclear, though family contact is a suspected source.
- Peptic ulcer disease in children is a significant concern, with the etiology often undetermined.
Purpose of the Study:
- To investigate the prevalence of H. pylori infection in children with peptic ulcers and their first-degree relatives.
- To explore the potential for person-to-person transmission of H. pylori within families.
Main Methods:
- Serum samples were analyzed for H. pylori IgG, pepsinogen I, and gastrin levels.
- Endoscopy with gastric antrum biopsies for histology, microbiology, and urease testing was performed on children and relatives.
- H. pylori infection status was determined in 15 children with peptic ulcers and their families.
Main Results:
- H. pylori was detected in 55% of children with duodenal ulcers and 50% of children with gastric ulcers.
- Infection rates were significantly higher in parents (87%) and siblings (61%) of H. pylori-positive children compared to H. pylori-negative children's families.
- Serum anti-H. pylori IgG level proved a reliable screening method for infection.
Conclusions:
- The findings support person-to-person transmission of H. pylori within families.
- The study raises questions about the direct pathogenetic role of H. pylori in all cases of childhood peptic ulceration.
- H. pylori infection is a significant factor to consider in pediatric peptic ulcer disease.
Abstract:
Little is known about the source and spread of Helicobacter pylori, but transmission from infected family contacts has been suggested. We have therefore investigated 15 children with peptic ulcer and their first-degree relatives for H. pylori. Serum anti-H. pylori IgG, pepsinogen I, and gastrin levels were measured. Endoscopy was carried out on the children and relatives, and biopsies were taken from the gastric antrum for histology, microbiology, and urease testing. Six of 11 children with duodenal ulcer (55%) and two of four children with gastric ulcer (50%) were positive for H. pylori. Fourteen of 16 parents (87%) and eight of 13 siblings (61%) of H. pylori-positive children with peptic ulcer were also infected compared with eight of 14 parents (57%) and none of four siblings of H. pylori-negative children with peptic ulcer (P less than 0.10, greater than 0.05, and NS, respectively). The children with H. pylori-negative peptic ulcer and negative siblings combined were younger than positive children with peptic ulcer and positive siblings (P less than 0.001). The reliability of serum anti-H. pylori IgG level as a screening test for infection was confirmed. These findings call into question a pathogenetic role for H. pylori in some childhood peptic ulceration, but do suggest that person-to-person spread of infection occurs.