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Atrophic gastritis: Helicobacter pylori versus duodenogastric reflux
Kinga Cristina Slăvescu1, Camelia Mărgescu2, Alexandru Pîrvan3
1Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
Atrophic gastritis affects 16.6% of children, appearing even in infants. Endoscopic findings do not reliably indicate atrophy, and duodenogastric reflux is a common association requiring further study.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Digestive Diseases
Background:
- Atrophic gastritis (AG) is a condition characterized by the loss of gastric glands.
- Its prevalence and clinical implications in pediatric populations are not well-established.
- Understanding AG in children is crucial for early diagnosis and management.
Purpose of the Study:
- To determine the prevalence of atrophic gastritis in children.
- To compare clinical manifestations, endoscopic findings, and atrophy severity in pediatric patients.
- To identify potential etiological factors contributing to gastric atrophy in children.
Main Methods:
- A cohort of 247 children diagnosed with chronic gastritis was evaluated.
- Atrophy was histologically defined as the loss of normal glandular components.
- Clinical data, endoscopic appearances, and histological findings were analyzed.
Main Results:
- The prevalence of atrophic gastritis was 16.6% (41/247 children).
- Clinical symptoms varied by age, with weight loss in infants and abdominal pain in older children.
- Atrophy severity ranged from mild to severe, with duodenogastric reflux identified in 14 cases, H. pylori in 5, and H. heilmannii in 2.
Conclusions:
- Atrophic gastritis is a recognized condition in childhood, affecting even very young children.
- Endoscopic appearance is not a reliable indicator of atrophy presence or severity.
- Duodenogastric reflux is frequently associated with gastric atrophy in children, warranting further investigation into its role.
Objectives:
The objective of this study was to asses the prevalence of atrophic gastritis in children. We also wanted to compare the clinical manifestation, endoscopic appearance and the degree of the gastric atrophy in children and to identify the possible causes which determine gastric atrophy.
Methods:
We evaluated 247 children with chronic gastritis (153 female/94 male, mean age 12.32 years). Atrophy was defined as the loss of normal glandular components, including replacement with fibrosis and/or intestinal metaplasia.
Results:
The prevalence of the atrophic gastritis was 16.6% (41 cases), mean age 11.59+/-1.75 years, male-to-female ratio 16:25. The clinical manifestations were correlated with the patient age (infants and toddlers were evaluated mostly for weight loss - 4 cases, and older children for abdominal pain - 22 cases). The endoscopic appearance was described as either nodular (15 cases), or erythematous gastritis (10 cases), or normal (10 cases). According to the Sydney System, the degree of atrophy was found to be mild in 3 patients, moderate in 25, and severe in 13 patients; 14 cases were associated with duodenogastric reflux, 5 with Helicobacter pylori and 2 with Helicobacter heilmannii infection, but in 17 cases the etiology was unknown.
Conclusions:
Atrophic gastritis is present in childhood, even at very young ages (infants, toddlers). The endoscopic appearance is not characteristic for the presence of atrophy. The degree of the atrophy is not correlated with the age of the children. Because of the relatively high number of duodenogastric reflux associated with gastric atrophy, further studies need to evaluate the potential causes and clinical course.
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