[Chronic gastritis in children]

ABSTRACT

Active gastritis, atrophic gastritis [AG] and intestinal metaplasia are lesions associated with Helicobacter pylon [H. pylon] infection in adults. To assess the prevalence of chronic gastritis, its histological characteristics and clinical features in children. 345 children [M/F 151/194, mean age 8.6 +/- 3.7 years; range 1-18 years] were enrolled, referred for upper gastrointestinal endoscopy [UGI endo] with clinical manifestations of gastritis, i.e., recurrent abdominal pain [n=232, 67.2%], upper gastrointestinal bleeding [n=59, 17.1%] and miscellaneous [n=53, 15.3%]. Four per-endoscopic gastric biopsy specimens [antrum 2, fundua 2] were taken. Biopsies were assessed and graded according to the updated Sydney system. H. pylon infection was considered if 2 out 3 tests were positive [culture, histology and rapid unease teat], whereas 3 concordant negative results identified H. pylon negative children. H. pylon infection and chronic gastritis were detected in 215/345 [62.3%] [M/F. 104/1 17, sex ratio M/F=0.89] and 221/345 [64.05%] children, respectively. Recurrent abdominal pain [n=149, 67.4%] was the main clinical features of chronic gastritis followed by vomiting [n=43, 19.5%] and upper gastrointestinal bleeding [n=4l, 18.6%]. Any clinical features were however found to be specific. UGI endo showed; nodular gastritis [n=90, 40.72%], congestive gastnitis [n=84, 38%], gastric ulcer [n=9], bulbar ulcer [n=5] and normal [n=47, 21 2%]. Chronic gastritis was active in 115 cases [52%] and was significantly associated with nodular gastritis [p<0.05]. Thirty two chronic gastnitis [14.4%] exhibited AG [M/F 16/16, mean age 9.4 +/- 3.4 years] and 30/32 [93.7%] were H. pylon positive. AG was significantly associated with H. pylon infection [p<0.0001] and nodular gastritis [p<0.005]. Active, follicular and AG were significantly associated with H. pylon infection [p <0.00001]. Three patients exhibited intestinal metaplasia. Chronic gastnitis is frequent in children. Any clinical features were found to be specific. It significantly associated H. pylon infection and nodular gastnitis. Atrophic gastnitis was found in 145%of children