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A study of Helicobacter-pylori in 100 pediatric patients from the Tri-State area
Insights
Helicobacter pylori (HP) is linked to gastritis in children, but not duodenitis or esophagitis. This study found HP highly associated with pediatric gastritis, though diagnostic tests showed limitations.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori (HP) is a pathogen linked to peptic ulcer disease.
- Pediatric upper gastrointestinal (GI) symptoms require investigation into potential causes like HP.
Purpose of the Study:
- To review pediatric patients undergoing upper endoscopy for HP evaluation.
- To determine the association of HP with GI mucosal inflammation, gastritis, duodenitis, and esophagitis in children.
Main Methods:
- Retrospective chart review of 100 pediatric patients evaluated between July 1990 and March 1993.
- HP diagnosis utilized CLO-test and histological confirmation.
- Analysis of presenting symptoms, endoscopic findings, and association with HP.
Main Results:
- Abdominal pain was the most common presenting symptom (53%).
- GI mucosal inflammation occurred in 77% of patients, with 41% associated with HP.
- HP was significantly associated with gastritis (HP+ vs. HP-) but not duodenitis or esophagitis. Two duodenal ulcers were HP+.
Conclusions:
- Pediatric HP infection is strongly associated with gastritis.
- HP does not appear to be a significant factor in pediatric duodenitis or esophagitis.
- The CLO-test demonstrated a high failure rate in identifying HP in mucosal biopsies.
Abstract:
Helicobacter pylori (HP) is a newly discovered pathogen implicated in the pathophysiology of peptic ulcer disease. The aim of this study was to review all pediatric patients who were evaluated by upper endoscopy through the Pediatric Gastroenterology Service at the Marshall University School of Medicine between July 1990 and March 1993. A total of 100 charts were retrospectively reviewed. HP was diagnosed by CLO-test and confirmed histologically. Results showed that the major presenting symptom was abdominal pain (53%). GI mucosal inflammation was found in 77 patients, and 41% of these cases were associated with HP. Two patients had duodenal ulcer; both were HP+. The incidence of gastritis was significantly higher in patients with HP+ compared to HP-. Follow-up on the HP-associated gastritis showed no significant difference in their clinical response irrespective to the treatment, we conclude that HP in children is highly associated with gastritis, but not duodenitis or esophagitis; and in our experience, that CLO has a high failure rate in identifying HP in the mucosa.