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Helicobacter pylori infection in children with celiac disease: prevalence and clinicopathologic features
1Dipartimento di Medicina Sperimentale e Clinica, Università di Catanzaro Magna Graecia, Italy.
Insights
Helicobacter pylori (H. pylori) infection prevalence and symptoms are similar in children with and without celiac disease. Gluten withdrawal resolves symptoms in celiac patients, regardless of H. pylori status.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Gastrointestinal Pathology
Background:
- Celiac disease is often linked to chronic gastritis.
- Helicobacter pylori is a primary cause of chronic gastritis.
- Understanding H. pylori's role in pediatric celiac disease is crucial.
Purpose of the Study:
- To determine H. pylori prevalence in children with celiac disease.
- To assess H. pylori-related symptoms in these children.
- To evaluate endoscopic and histologic gastric features in pediatric celiac disease patients with H. pylori.
Main Methods:
- Studied 81 children with celiac disease and matched controls.
- Collected blood samples for H. pylori IgG testing.
- Performed endoscopy and gastric biopsies in a subgroup for histology and urease testing.
Main Results:
- H. pylori positivity was 18.5% in celiac children and 17.3% in controls.
- Recurrent abdominal pain was the only distinguishing symptom, resolving with gluten withdrawal.
- No significant differences in endoscopic or histologic findings between celiac and non-celiac H. pylori-positive children were observed.
Conclusions:
- H. pylori prevalence and clinical impact are not elevated in children with celiac disease.
- The clinicopathologic presentation of H. pylori infection is not specifically altered by celiac disease.
Background:
Celiac disease is frequently associated with chronic gastritis. Helicobacter pylori is the main etiologic agent of chronic gastritis. The aim of this study was to assess the prevalence of H. pylori, the related symptoms, and the endoscopic and histologic gastric features in children with celiac disease.
Methods:
Eight-one (24 boys, 57 girls; age range: 1.4-17.7 years, median 6.8) children with celiac disease were studied. All children had a blood sample taken. In a subgroup of 30 children who underwent endoscopy, three gastric biopsy specimens were taken for histology (hematoxylin and eosin, Giemsa, immunohistochemistry) and urease quick test. Symptom complaints were recorded. Age- and sex-matched (one case, one control) children without celiac disease were used for comparison. Serum H. pylori IgG were measured by means of a locally validated commercial enzyme-linked immunoassay.
Results:
Overall, 15 of 81 (18.5%) children with celiac disease and 14 of 81 (17.3%) control children were positive for H. pylori. The percentage of H. pylori positivity was similar in children with untreated and treated celiac disease. Recurrent abdominal pain was the only symptom that helped to distinguish between H. pylori-positive and H. pylori-negative children. However, symptoms disappeared in patients with celiac disease after gluten withdrawal, irrespective of H. pylori status. All endoscopic (erythema, nodularity) and histologic (superficial-, interstitial-, lymphocytic-gastritis, activity, lymphoid follicles) findings did not differ between celiac and nonceliac H. pylori-positive children.
Conclusions:
Prevalence and clinical expressivity of H. pylori infection is not increased in children with celiac disease. The clinicopathologic pattern of the infection is not specifically influenced in this condition.