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Endoscopic and histopathological findings in children with growth retardation
1Division of Pediatric Gastroenterology, Department of Child Health and Diseases, Kahramanmaras City Hospital, Kahramanmaras, Turkiye.
Insights
Endoscopic evaluation revealed significant gastrointestinal findings in all children with persistent growth retardation, even without typical symptoms. These results highlight the importance of endoscopy in diagnosing underlying conditions contributing to poor growth in pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Diagnostic Endoscopy
Background:
- Growth retardation in children can stem from various underlying medical conditions.
- Adequate caloric support is crucial, but persistent growth issues warrant further investigation.
- Identifying the root cause of growth failure is essential for effective intervention.
Purpose of the Study:
- To characterize the clinical, endoscopic, and histopathological features of children experiencing growth retardation.
- To investigate the utility of upper gastrointestinal endoscopy in evaluating pediatric patients with persistent growth failure.
- To determine the prevalence of specific gastrointestinal conditions in this cohort.
Main Methods:
- A cohort of 90 children (aged 2-18 years) with growth retardation, despite adequate caloric intake for at least 3 months, were included.
- All participants underwent oesophagogastroduodenoscopy (EGD) for diagnostic purposes.
- Clinical data, including nutritional status, symptoms, and laboratory results (celiac antibodies, iron, B12 levels), were collected and analyzed.
Main Results:
- The majority of patients exhibited malnutrition (88.9%) and common endoscopic findings included pangastritis (88.9%), duodenitis (61.1%), and bile reflux (35.6%).
- Histopathological examination revealed high rates of chronic Helicobacter pylori gastritis (72.2%), celiac disease (20.0%), and reflux esophagitis (17.8%).
- Importantly, significant endoscopic findings were present in all children, irrespective of accompanying dyspeptic symptoms, and no association was found between H. pylori gastritis and nutritional status or deficiencies.
Conclusions:
- Endoscopy is a valuable tool for identifying gastrointestinal pathologies in children with persistent growth retardation, even in the absence of overt symptoms.
- The findings underscore the need for considering endoscopic evaluation in the diagnostic workup of pediatric growth failure.
- Further research is warranted to fully elucidate the role and optimal application of endoscopy in this patient population.
Objective:
The study aimed to describe the clinical characteristics, endoscopic and histopathological findings of children admitted to the paediatric gastroenterology outpatient clinic for growth retardation.
Methods:
The study was carried out with 90 patients aged 2-18 years who presented to our paediatric gastroenterology outpatient clinic with complaints of growth retardation and underwent oesophagogastroduodenoscopy (EGD) because growth retardation persisted despite adequate caloric support (at least 3 months).
Results:
The mean age of the patients was 11.11±4.27 years, 56 (62.2%) were female and 52 (57.8%) were under 12 years of age. Of the patients, 36.7% had mild, 47.8% moderate and 15.6% severe acute malnutrition, 22.2% stunting and 7.8% severe stunting. Associated dyspeptic symptoms were present in 34 (37.8%) patients and celiac antibodies were positive in 20 (22.2%) patients. Iron deficiency was present in 28.9% and B12 deficiency in 41.1% of the patients. The most common endoscopic findings were pangastritis (88.9%), duodenitis (61.1%), bile reflux (35.6%) and bulbitis (31.1%). Chronic Helicobacter pylori (H. pylori) gastritis was found in 72.2%, celiac disease in 20.0% and reflux oesophagitis in 17.8% of the patients. No association was found between chronic H. pylori gastritis and iron deficiency anaemia and vitamin B12 deficiency (p=0.90, p=0.89). There was no association between chronic H. pylori gastritis and height-for-age, weight-for-height and BMI z scores (0.31, 0.57, 0.43).
Conclusion:
In this study, positive endoscopic findings were found in all children with persistent growth retardation despite adequate caloric support, even in the absence of accompanying dyspeptic symptoms. More studies evaluating the usefulness of endoscopy in children with growth retardation are needed.
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