Helicobacter pylori infection in Saudi children; clinical, endoscopic and pathological findings

ABSTRACT

Helicobacter pylori [H. pylori] infection is common in the Saudi paediatric population. The aim of this study was to describe the clinical presentation, endoscopic abnormalities and associated histopathological changes in a group of Saudi children with H. pylori infection. This is a chart review of all Saudi children diagnosed at King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia, between September 2001 and July 2005 with H. pylori infection. A total of 230 children were identified. One hundred and thirty six [55%] were females. The mean age was 11 +/- 3.9 years [range, 2-7]. Thirty-two [14%] were underweight and 12 [5%] were stunted. The main symptom was epigastric pain in 128 [56%]. Nodular gastritis was the most frequent endoscopic finding in 94 patients [40%]. The histopathological findings in the antrum showed moderate chronic inflammatory activity in 65%, mild glandular atrophy in 14% and intestinal metaplasia in 2%. In the corpus, moderate chronic inflammatory activity was found in more than 50%, glandular atrophy in 7%, and cases with intestinal metaplasia. The density of H.pylori in the antrum was mild in 67% and moderate in 26% of cases. In the corpus, it was mild in 49% and moderate in 21% of patients. The mean gastritis score was 4.2 +/- 1.3 in the antrum and 3,4 +/- 1.3 in the corpus. Nodular gastritis was associated with the highest mean gastritis score of 4.9 +/- 1.2 in the antrum [ANOVA < 0.001]. The severity of gastritis in the antrum and the corpus was associated with higher density of H. pylori [ANOVA < 0.001]. Saudi children with H.pylori infection were commonly found to have abnormal endoscopic findings which were associated with significant gastric mucosal inflammation