Gastric Antral Mucosal Changes in Children With Intestinal Metaplasia.

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Pathology

Background:

• Gastric antral intestinal metaplasia (IM) is a recognized condition, but its characteristics and implications in the pediatric population are not well-defined.
• Understanding associated mucosal changes and clinical outcomes in children is crucial for accurate diagnosis and management.

Purpose of the Study:

• To investigate the prevalence of gastric antral intestinal metaplasia (IM) in patients under 18 years old.
• To identify coexisting pathological findings alongside antral IM in pediatric patients.
• To assess the persistence of IM and the presence of dysplasia in follow-up biopsies.

Main Methods:

• Retrospective review of upper GI endoscopy and pathology reports for patients under 18 diagnosed with antral IM between 2009 and 2020.
• Evaluation of biopsies for IM, dysplasia, Helicobacter pylori, gastritis, and other pathological changes.
• Analysis of follow-up biopsies to determine the persistence of IM and development of dysplasia.

Main Results:

• 134 pediatric patients with antral IM were identified; 53.7% had coexisting pathologies like chronic gastritis and reactive gastropathy.
• Isolated IM was found in 46.3% of cases. IM prevalence increased with age and was more common in females.
• Of 27 patients with follow-up, 40.7% showed persistent IM; no cases of dysplasia were observed.

Conclusions:

• Pediatric gastric antral IM is often associated with other gastric pathologies and its incidence rises with age.
• Gastric IM can be persistent in children, lasting months to years, especially in cases with chronic gastritis and gastric eosinophilia.
• The absence of dysplasia in this cohort suggests a potentially benign course for pediatric IM, warranting further long-term studies.