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Natural Progression of Helicobacter pylori-Negative Gastritis with Lymphoid Follicles in Children: Prospective
Vered Richter1, Sonia Mendlovic2, Tzipi Shalem3
1The Gonczarowski Family Institute of Gastroenterology and Liver Disease, Shamir Medical Center, Zerifin, Israel.
Insights
In children with Helicobacter pylori-negative gastritis, lymphoid follicles (LFs) often persist even after gastritis resolves. These findings suggest LFs may be a non-pathological feature in pediatric gastritis, not requiring further follow-up.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Microbiome Research
Background:
- The significance of lymphoid follicles (LFs) in pediatric H. pylori-negative gastritis remains unclear.
- Understanding the natural history of this condition is crucial for appropriate clinical management.
Purpose of the Study:
- To investigate the natural history and clinical significance of H. pylori-negative gastritis with LFs in children.
- To determine if LFs in pediatric gastritis represent a pathological finding requiring intervention.
Main Methods:
- Retrospective identification of pediatric patients with H. pylori-negative gastritis and LFs.
- Follow-up esophagogastroduodenoscopy (EGD) and histological review.
- Comparison of initial and follow-up clinical, endoscopic, and histological findings.
Main Results:
- Of 48 children with H. pylori-negative gastritis, 17 (35.41%) had LFs.
- In a subset of 8 children followed for a mean of 25.58 months, LFs persisted in 3 despite chronic gastritis.
- Four children showed gastritis resolution but retained LFs; one resolved both.
- One patient had resolution of both gastritis and LFs.
Conclusions:
- Lymphoid follicles (LFs) can persist in children with H. pylori-negative gastritis for up to two years.
- LFs may remain present even after the resolution of gastritis.
- This histological finding is likely a non-pathological feature in children and may not necessitate further follow-up or intervention.
Background:
The association of Helicobacter pylori-negative gastritis with lymphoid follicles (LFs) in children is still unclear. Therefore, we aimed to investigate the natural history and significance of H. pylori-negative gastritis with LFs in children.
Methods:
We identified children with histologically proven H. pylori-negative gastritis with LFs between June 2014 and January 2017. The children were invited for a follow-up examination. The clinical, endoscopic, and histological findings of the index esophagogastroduodenoscopy (EGD) were revised and compared to the follow-up findings.
Results:
A total of 754 children underwent EGD. Among the 48 children diagnosed with H. pylori-negative gastritis, 17 (35.41%) had gastric LFs. Eight agreed to participate in the study. The mean follow-up was 25.58 ± 4.52 (range, 20.53-35.73) months. Three children still had histologic findings of chronic gastritis with LFs. Four children had resolution of the gastritis but still had LFs, and 1 patient had resolution of both the gastritis and LFs.
Conclusion:
LFs were still present in children with H. pylori-negative gastritis after a mean follow-up of 2 years, and in some children, despite resolution of the gastritis. Therefore, this histological finding might be a non-pathological feature in children and does not need any contribution or follow-up.
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