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Celiac disease and Helicobacter pylori infection in children: Is there any Association?
Manish Narang1, Amarender Singh Puri1, Sanjeev Sachdeva1
1Department of Gastroenterology, GB Pant Institute of Post Graduate Medical Education and Research, Delhi, India.
Insights
The study found a lower prevalence of Helicobacter pylori (HP) infection in children with celiac disease (CD) compared to healthy children. This inverse relationship suggests HP infection may offer protection against developing CD.
Area of Science:
- Gastroenterology
- Pediatric Immunology
- Microbiome Research
Background:
- Helicobacter pylori (HP) infection can modulate gut immunity, potentially influencing celiac disease (CD) development in susceptible children.
- Understanding the interplay between HP infection and CD is crucial for pediatric gastrointestinal health.
Purpose of the Study:
- To investigate the relationship between celiac disease and HP infection in pediatric patients.
- To compare HP prevalence in children with confirmed CD versus a non-celiac control group.
- To identify predictors of HP infection within the pediatric CD population.
Main Methods:
- Retrospective analysis of 324 children (1-18 years) diagnosed with Marsh grade III celiac disease.
- Comparison of HP prevalence in CD patients with a control group of non-celiac children undergoing endoscopy.
- Multivariate regression analysis to determine independent predictors of HP infection in CD patients.
Main Results:
- Gastric HP infection was present in 11.4% of children with celiac disease.
- HP prevalence was significantly higher in the non-celiac control group (50%, P < 0.001).
- Gastritis, hemoglobin levels, and absence of duodenal scalloping were independent predictors of HP infection in CD patients.
Conclusions:
- An inverse relationship exists between celiac disease and gastric HP infection in children.
- The findings raise the possibility that HP infection may confer a protective effect against the development of celiac disease.
Background And Aim:
Helicobacter pylori (HP) infection can influence the inflammatory and immune responses in the gut and may therefore play a role in the development of gluten-related enteropathy in genetically susceptible individuals. Our objective was to assess the relationship between celiac disease and HP infection in children.
Methods:
Children (1-18 years) diagnosed as celiac disease (CD) (n = 324) with submission of gastric and duodenal biopsies and duodenal histology having Marsh grade III features were eligible for the study. Non-celiac patients referred for endoscopy were selected as controls. We studied proportion of HP prevalence in children with confirmed CD as compared with HP prevalence in reference group comprising non-celiac children referred for endoscopy. We also evaluated predictors of HP infection in children with celiac disease.
Results:
Of the 324 participants with CD, gastric HP was seen in 37 (11.4%) patients. The prevalence of HP in patients without CD (50%, P < 0.001) was significantly higher. Among patients with CD, HP infection was most frequent in patients with Marsh IIIa. In the stepwise regression analysis for risk factors of HP infection in CD patients: presence of gastritis, hemoglobin, and absence of scalloping were found to be independent predictors in a multivariate setup.
Conclusion:
Celiac disease and gastric HP infection have inverse relationship that raises the question whether development of HP infection confers protection against CD.
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