Effect of chronic helicobacter pylori infection on growth and iron status in school children

ABSTRACT

Helicobacter pylori is probably the commonest bacterial infection of humans. The infection is likely to be acquired in childhood. Little is known about the effects of this chronic and lifelong infection on growth of infected. The aim of this work was to investigate the true effect of chronic Helicobacter pylori infection on growth and iron status of school children. Also to study the effect of eradication of H pylori on the management of iron deficiency anemia in this age group. This study was carried out on 60 school children, 34 males and 26 females whose ages ranged from 6 to 14 years. They were selected from the outpatient pediatric clinics during the period from August 2000 to November 2001. These children were classified into three groups. Group I Included 21 children infected with H. pylori and had no evidence of iron deficiency. Group II Included 16 H pylori infected children with proved iron deficiency anemia. Group III Included 23 normal healthy control children. The diagnosis of H. pylori infection was based on the detection of serum IgG anti-Helicobacter pylori antibodies by ELISA technique. Each case was subjected to a thorough clinical examination and complete environmental history with emphasis on risk factors for H pylori infection. The following investigations were carried out for all cases hemoglobin levels, MCV values, reticulocytic counts, serum iron levels, total iron binding capacity, and serum ferritin levels. Our findings confirmed a significant association between low socioeconomic classes, lack of running water, overcrowded unsanitary homes and H pylori infection. We also found that the means of children 's weight and height values were significantly decreased [p value <0.05 and <0.01 respectively] in the group II having both H pylori and iron deficiency anemia compared to the control group. After eradication of H pylori infection, iron therapy resulted in a significant increase in the mean levels of hemoglobin, hematocrit, serum iron and serum ferritin when compared with the mean levels before eradication. In conclusion, chronic H pylori infection is one of the environmental hazards, which may affect the growth and the iron status of school children that are in need for larger amount of iron to meet their rapid growth requirements. H pylori infection should be suspected when IDA is refractory to iron administration in older children. We also propose that treatment for iron deficiency anemia coexistent with H pylori infection should include H pylori eradication