[Features of mucosal lesions of stomach and duodenum in children with chronic gastroduodenitis with different
Insights
Histological features in children with chronic gastroduodenitis vary based on microflora. Bacterial (Helicobacter pylori) and viral infections cause distinct inflammatory and dystrophic changes in the stomach and duodenum.
Area of Science:
- Pediatric Gastroenterology
- Microbiology
- Histopathology
Background:
- Chronic gastroduodenitis is a common condition in children.
- The role of specific microflora in the pathogenesis of gastroduodenitis requires further elucidation.
Purpose of the Study:
- To reveal histological features of gastric and duodenal mucosa in children with chronic gastroduodenitis.
- To correlate these features with the composition of stomach and duodenal microflora.
Main Methods:
- 122 children (5-17 years) with chronic gastroduodenitis were studied.
- Endoscopy with histology and morphometry of gastric and duodenal mucosa biopsies.
- Polymerase chain reaction (PCR) used to detect Helicobacter pylori, herpes simplex virus (HSV) 1/2, cytomegalovirus (CMV), and human papillomavirus (HPV) 16/18.
Main Results:
- Four groups were identified: no microorganisms (n=51), H. pylori and viruses (n=28), viruses only (n=15), and H. pylori only (n=28).
- H. pylori was associated with antral inflammation and duodenal dystrophic changes.
- Viral infections correlated with inflammation in the fundal stomach and duodenum.
- Mixed viral-bacterial infections showed pronounced inflammatory-dystrophic changes throughout the gastroduodenal mucosa.
Conclusions:
- Distinct histological features of the gastric and duodenal mucosa are associated with different microflora compositions in children with chronic gastroduodenitis.
- The localization and severity of inflammatory and dystrophic changes differ based on the presence of bacterial, viral, or mixed infections.
Objective:
Our aim was to reveale the features of histological mucosa with different composition of the microflora of stomach and duodenum in children with chronic gastroduodenitis.
Methods:
The study included 122 children with chronic gastroduodenitis from 5 to 17 years old. All patients underwent endoscopy with histology of biopsy specimens of gastric and duodenal mucosa in 94 patients and in 48 patients among them with morphometry of biological material. Identification of herpes simplex virus 1, 2 types, cytomegalovirus, human papilloma virus 16, 18 types, Helicobacterpylori was carried out using polymerase chain reaction in biopsies of gastroduodenal mucosa and gastric juice.
Results:
Children with chronic gastroduodenitis depending on the identified microorganisms were divided into groups: 1st (n = 51)--without detectable microorganisms, 2nd (n = 28)--with associations of H. pylori and viruses, 3rd (n = 15)--only with viruses, 4th (n = 28)--with H. pylori. Thus, in patients with H. pylori inflammation was noted mainly in the antral mucosa and dystrophic changes--in the duodenal mucosa. In the presence of viruses the inflammation was expressed more in the fundal stomach and duodenum. When viral-bacterial associations were observed most pronounced inflammatory-dystrophic process was localized throughout the gastroduodenal mucosa.
Conclusion:
In children with chronic gastroduodenitis in the presence of bacterial, viral and mixed microflora in the stomach and duodenum identified characteristic histological features of the mucosa, manifested in a different localization and severity of inflammatory and dystrophic changes.
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