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Nodular gastritis: an endoscopic indicator of Helicobacter pylori infection in children
Sonia Mazigh Mrad1, Kamel Abidi, Ines Brini
1Department of Medicine C, Children Hospital, Tunis, Tunisia.
Insights
Endoscopic nodular gastritis in children is a strong indicator of Helicobacter pylori (Hp) infection, often associated with active chronic follicular gastritis. This finding aids in diagnosing Hp infection in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Endoscopic Diagnostics
Background:
- Helicobacter pylori (Hp) infection is a widespread bacterial infection, frequently acquired during childhood.
- Chronic abdominal pain is a common presenting symptom in children requiring gastrointestinal evaluation.
Purpose of the Study:
- To determine the association between endoscopic findings of nodular gastritis and Hp infection in children.
- To evaluate the diagnostic accuracy of nodular gastritis for identifying Hp infection.
Main Methods:
- Retrospective analysis of pediatric patients undergoing upper endoscopy for chronic abdominal pain.
- Histologic analysis of five gastric biopsies, urease testing, and Hp culture were performed.
- Sensitivity, specificity, and predictive values of nodular gastritis were calculated; associated clinical and histologic parameters were analyzed.
Main Results:
- Helicobacter pylori infection was diagnosed in 71.5% of the 49 eligible children.
- Nodular gastritis was present in 16 children, predominantly in those with Hp infection (14/16).
- Nodular gastritis showed 40% sensitivity and 85.7% specificity for Hp infection; older age, Hp infection, and specific gastritis patterns were significantly associated.
Conclusions:
- The endoscopic finding of antral nodularity is a valuable indicator for identifying Hp infection in children.
- Nodular gastritis in children is strongly linked to active chronic follicular gastritis in the presence of Hp infection.
Background:
Helicobacter pylori (Hp) infection is a common and universally distributed bacterial infection. It is predominantly acquired in childhood.
Aim:
To assess the relationship between endoscopic nodular gastritis and Hp infection.
Methods:
A retrospective study was conducted in children who underwent upper gastrointestinal endoscopy for chronic abdominal pain. All children who had five gastric biopsies for histologic analysis, urease test and Hp culture were included in the study. The Sensitivity and sensibility of nodular gastritis were determined and different parameters were studied according the presence or not of nodular gastritis(age, gender, Hp status, gastritis score and lymphoid follicles).
Results:
49 children, mean age 6.9 ± 3 years (range 1-12 years) were eligible for the analysis. Hp Infection was diagnosed in 35 out of the 49 children (71.5 %). Nodular gastritis was recorded in 16 out of 49 children and in 14 infected children and 2 out of 14 non infected children (p=0.07), 40% sensitivity, 85.7% specificity, 87.5% positive predictive value, and 36,4% negative predictive value. The parameters associated significantly to the presence of nodular gastritis were older age: (p=0.04), Hp infection: (p=0.01), chronic gastritis: (p=0.05), active gastritis: (p=0.02), follicular gastritis: (p=0.005), higher gastritis score: (p=0.005). Completely normal gastric mucosal histology was never found in infected children with antral nodularity. Among all infected children, the gastritis score was significantly higher when there was a nodular gastritis and follicular gastritis was significantly associated to nodular gastritis.
Conclusion:
The endoscopic pattern of antral nodularity identifies children with Hp infection, and active chronic follicular gastritis.
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