Normal gastric histology in Helicobacter pylori-infected children
1Service de Pédiatrie, Hôpital Huriez, Lille, France.
Insights
Helicobacter pylori (H. pylori) infection in children can present with normal gastric histology, unlike in adults where it typically causes gastritis or ulcers. This study found H. pylori in children with both normal and abnormal gastric findings.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Helicobacter pylori (H. pylori) infection is consistently linked to gastritis or ulcers in adults.
- Gastritis and ulcers are infrequently observed in children with H. pylori infection.
- Understanding H. pylori's impact on pediatric gastric mucosa is crucial.
Purpose of the Study:
- To investigate the association between H. pylori infection and the condition of gastric mucosa in pediatric patients.
- To determine if H. pylori infection in children always leads to visible gastric pathology.
Main Methods:
- Retrospective study of 80 children and adolescents (2 months-22 years) with H. pylori infection.
- Inclusion of 48 institutionalized, neurologically impaired patients (60%).
- Gastroscopy with antral and fundic biopsies for histological and bacteriological analysis.
Main Results:
- A normal gastric mucosa was observed in 27.5% (22/80) of infected children.
- Gastritis was present in 72.5% (58/80) of the study cohort.
- No significant differences in age, sex, ethnicity, symptoms, or bacterial colonization levels were found between groups with normal versus abnormal histology.
Conclusions:
- H. pylori infection in children can coexist with normal gastric histology.
- The findings challenge the assumption that H. pylori always causes significant gastric pathology in pediatric populations.
- Further research is needed to understand the implications of H. pylori in children with normal histology.
Background:
In adults, Helicobacter pylori infection is always associated with gastritis or ulcer. However, very active gastritis and ulcers are rarely seen in children. The aim of the present work was to study the relationships between H. pylori and gastric mucosa in children.
Methods:
Eighty infected children and adolescents including 48 (60%) neurologically impaired institutionalized patients, aged 2 months-22 years (mean 11.7 +/- 5.2 years) were studied retrospectively. All the patients underwent gastroscopy, and three antral and two fundic biopsy specimens were taken for histology and bacteriology.
Results:
A normal gastric mucosa was found in 22 of 80 patients (27.5%), whereas the others had gastritis (n = 58, 72.5%). There were no statistical differences between patients with normal histology and those presenting with gastritis for age, sex, ethnic background, symptoms, and the degree of bacterial colonization. The macroscopic aspect of gastritis was less frequently found in children with a normal histology compared with those with histological gastritis (p < 0.001).
Conclusions:
These data show that H. pylori infection can be associated with a normal gastric histology in children.
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