Related Experiment Videos
Campylobacter pylori--associated gastritis and peptic ulcer disease in children
P M Kilbridge1, B B Dahms, S J Czinn
1School of Medicine, Case Western Reserve University, OH.
Insights
Campylobacter pylori (CP) infection is strongly linked to chronic gastritis and duodenal ulcers in children. Eradicating CP may resolve symptoms, but high relapse rates occur in patients with gastritis and ulcers.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Campylobacter pylori (CP), a gram-negative bacillus, is associated with gastritis and peptic ulcer disease in adults.
- Pediatric gastric biopsies are reviewed to assess CP presence in children aged 5-17 with suspected acid peptic disease.
Purpose of the Study:
- To investigate the association between Campylobacter pylori (CP) colonization and chronic gastritis and peptic ulcer disease in pediatric patients.
- To evaluate the prevalence of CP in children with histologically confirmed gastritis.
Main Methods:
- Retrospective review of gastric biopsy specimens from 98 pediatric patients (ages 5-17).
- Histological examination for chronic gastritis and presence of Campylobacter pylori (CP).
- Correlation of CP presence with gastritis severity and peptic ulcer disease (duodenal and gastric ulcers).
Main Results:
- Of 40 patients with chronic gastritis, 22 (55%) had CP; none of the 58 without gastritis had CP.
- Gastritis was more severe in children with CP (86% moderate, 92% severe).
- CP was present in 8/8 duodenal ulcer patients and 1/1 gastric ulcer patient with ulcers; only 1/9 patients without CP had a duodenal ulcer.
Conclusions:
- A strong association exists between CP stomach colonization, chronic gastritis, and duodenal ulcer disease in children.
- While initial symptom resolution with acid-antagonist therapy was observed in CP-positive patients, high relapse rates were noted in those with concurrent gastritis and duodenal ulcers.
Abstract:
Specimens obtained at gastric biopsies performed for suspected acid peptic disease in patients 5 through 17 years of age were retrospectively reviewed for the presence of Campylobacter pylori (CP), a gram-negative bacillus associated with chronic gastritis and peptic ulcer disease in adults. Of 98 patients who underwent antral biopsy (the most reliably colonized site in the stomach), 40 had chronic gastritis histologically. Of those 40 patients, 22 (55%) had CP present on the gastric surface. None of the 58 patients without gastritis present in biopsy specimens had CP. The gastritis in children with CP was more severe than in those without the organism: 86% of those with moderate gastritis and 92% of those with severe gastritis had CP. Eight patients with duodenal ulcers and one patient with a gastric ulcer had CP on biopsy. Among those patients without CP, only one had a duodenal ulcer and eight had gastric ulcers. An additional nine patients found to have CP on gastric fundic biopsy were identified, for a total of 31 patients with CP identified by either antral (22) or fundic (nine) biopsy. Initial resolution of symptoms with standard acid-antagonist therapy was noted in the 25 of 31 CP(+) patients so treated, but a high relapse rate was noted within one to two years in the patients who also had gastritis and duodenal ulcer. These findings support a strong association between CP colonization of the stomach and the presence of chronic gastritis and duodenal ulcer disease in children.