[Symptomatology and specific characteristics of chronic gastritis caused by Helicobacter pylori infection in children in the Czech population--epidemiologic, clinical, endoscopic and histomorphologic study].Cas Lek Cesk. 2002 Sep; 141(19):615-21.CL
H. pylori infection is associated with gastritis and peptic ulcer in children and adults. H. pylori acquisition seems to occur predominantly in childhood. Some data have reported H. pylori non-related chronic gastritis. Little information is available about the relationship between H. pylori, clinicopathologic features and long-term effects of infection in childhood. The purpose of this study was to compare the differences between chronic gastritis due to H. pylori with those of chronic gastritis not associated with H. pylori infection.
METHODS AND RESULTS
92 children (13.8 +/- 3.5 years) were take into they shaded group. 51 children were H. pylori positive, 41 children had no evidence of H. pylori. Epidemiological and clinical data, endoscopic appearance and histologic examination were evaluated. There were no differences in age and gender among the children. There was a significant correlation between H. pylori infection and parental education (p < 0.05) and habitat crowding (the number of rooms). There were no differences in clinical diagnosis and occurrence of any predominant symptom between the two groups. There was an association with a detrimental influence on daily life and activities in H. pylori patients (p < 0.01). Extradigestive symptoms (chronic urticaria, sideropenic anemia) were significantly more common in the H. pylori positive group (p < 0.05). 21 children (41.6%) were H. pylori positive/cagA positive, 15 of them (30.3%) were H. pylori positive/vacA positive. Findings of antral nodularity were more frequent in H. pylori positive children than in H. pylori negative (p < 0.000001). There were no differences in erythematous gastritis, haemorrhage and mucosal ulceration. H. pylori density score did not differ in various part of the gastric mucosa (antrum, corpus). Chronic gastritis was found to be more severe in patients with H. pylori infection compared with H. pylori-negative gastritis. Statistically significant was the increased presence of neutrophils, edema, monocytes, lymphoid follicles, the intensity of inflammation and mucosal oedema in the gastric mucosa in H. pylori positive children. There were no differences in the incidence of foveolar hyperplasia, mucosal atrophy, intestinal metaplasia and erosion.
H. pylori related chronic gastritis may be considered as a specific form of inflammation and it may be associated with a typical clinical symptomatology in a subgroup of children in Czech population. Precautions in life style may diminish H. pylori-related disease in children.