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Campylobacter pyloridis-associated primary gastritis in children
Insights
Campylobacter pyloridis, a bacterium, is linked to primary gastritis in children. This organism was found in antral biopsies of children with unexplained gastritis but not in those with secondary causes or normal findings.
Area of Science:
- Microbiology
- Pediatric Gastroenterology
- Histopathology
Background:
- Campylobacter pyloridis (now Helicobacter pylori) is a spiral-shaped, Gram-negative bacterium.
- This bacterium has been associated with gastritis and peptic ulcer disease in adults.
- Detection in gastric antrum biopsies is typically done using silver staining.
Purpose of the Study:
- To investigate the prevalence of C. pyloridis colonization in pediatric antral mucosa.
- To determine the association between C. pyloridis and gastritis in children.
- To differentiate between primary and secondary gastritis in relation to C. pyloridis infection.
Main Methods:
- Retrospective review of 53 pediatric cases undergoing upper endoscopy with antral biopsy.
- Utilized silver impregnation staining to identify C. pyloridis in biopsy specimens.
- Histological examination of antral and duodenal biopsies to assess inflammation and identify C. pyloridis.
Main Results:
- Nineteen of 53 children had evidence of antral mucosal inflammation.
- C. pyloridis was identified in 6 out of 10 children with primary gastritis (no other apparent cause).
- C. pyloridis was not detected in children with secondary gastritis or those with normal antral histology; it was also absent in duodenal sections.
Conclusions:
- C. pyloridis is associated with primary antral gastritis in the pediatric population.
- The bacterium does not appear to be associated with secondary gastritis in children.
- The findings suggest a specific role for C. pyloridis in pediatric gastritis etiology.
Abstract:
Campylobacter pyloridis are spiral-shaped Gram-negative bacteria that have recently been associated with gastritis and peptic ulcer diseases in adults. The organisms have been identified in biopsy specimens of the gastric antrum by staining sections with silver stain. To determine the frequency of colonization of the antral mucosa with C pyloridis in association with gastritis in childhood, we retrospectively reviewed 53 cases in patients (mean age 11.9 years) in whom upper endoscopy with antral biopsy was performed for the evaluation of symptoms referable to the upper gastrointestinal tract. A silver impregnation method was used to detect the presence of C pyloridis. Nineteen of 53 antral biopsy specimens showed evidence of mucosal inflammation. Ten of these 19 patients had no apparent predisposing etiology for gastritis, and six of these ten had C pyloridis identified on antral biopsies. Nine of the 19 patients had secondary causes of gastric inflammation (two gastroduodenal Crohn disease, two eosinophilic gastroenteritis, four drug related, and one dys-gamma-globulinemia and lymphonodular hyperplasia). In contrast, none of these nine patients had C pyloridis demonstrated on antral biopsies. Silver stain for C pyloridis was negative in all 34 of the 53 children who had normal antral histologic findings. C pyloridis was not demonstrated by silver stain on any of the duodenal sections, although eight of the 19 children with gastritis and nine of the 34 children with normal antral histologic findings had histologic evidence of duodenal inflammation. We conclude that C pyloridis is associated with primary antral gastritis but not with secondary gastritis in the pediatric population.