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Helicobacter pylori-associated hypochlorhydria in children, and development of iron deficiency.
J Clin Pathol. 2013 Apr; 66(4):343-7.JC

Abstract

AIMS

Acute Helicobacter pylori infection is associated with transient hypochlorhydria. In H pylori-associated atrophy, hypochlorhydria has a role in iron deficiency (ID) through changes in the physiology of iron-complex absorption. The aims were to evaluate the association between H pylori-associated hypochlorhydria and ID in children.

METHODS

Symptomatic children (n=123) were prospectively enrolled. Blood, gastric juice and gastric biopsies were taken, respectively, for haematological analyses, pH assessment and H pylori determination, and duodenal biopsies for exclusion of coeliac disease. Stool samples were collected for parasitology/microbiology. Thirteen children were excluded following parasitology and duodenal histopathology, and five due to impaired blood analysis.

RESULTS

Ten children were hypochlorhydric (pH>4) and 33 were H pylori positive. In H pylori-positive children with pH>4 (n=6) serum iron and transferrin saturation levels % were significantly lower (p<0.01) than H pylori-positive children with pH≤4. No differences in ferritin, or total iron binding capacity, were observed. In H pylori-negative children with pH>4, iron and transferrin saturation were not significantly different from children with pH≤4.

CONCLUSIONS

Low serum iron and transferrin in childhood H pylori infection is associated with hypochlorhydria. In uninfected children, hypochlorhydria was not associated with altered serum iron parameters, indicating a combination of H pylori infection and/or inflammation, and hypochlorhydria has a role in the aetiology of ID. Although H pylori-associated hypochlorhydria is transient during acute gastritis, this alters iron homeostasis with clinical impact in developing countries with a high H pylori prevalence.

Authors+Show Affiliations

Division of Paediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23268321

Citation

Harris, Paul R., et al. "Helicobacter Pylori-associated Hypochlorhydria in Children, and Development of Iron Deficiency." Journal of Clinical Pathology, vol. 66, no. 4, 2013, pp. 343-7.
Harris PR, Serrano CA, Villagrán A, et al. Helicobacter pylori-associated hypochlorhydria in children, and development of iron deficiency. J Clin Pathol. 2013;66(4):343-7.
Harris, P. R., Serrano, C. A., Villagrán, A., Walker, M. M., Thomson, M., Duarte, I., Windle, H. J., & Crabtree, J. E. (2013). Helicobacter pylori-associated hypochlorhydria in children, and development of iron deficiency. Journal of Clinical Pathology, 66(4), 343-7. https://doi.org/10.1136/jclinpath-2012-201243
Harris PR, et al. Helicobacter Pylori-associated Hypochlorhydria in Children, and Development of Iron Deficiency. J Clin Pathol. 2013;66(4):343-7. PubMed PMID: 23268321.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Helicobacter pylori-associated hypochlorhydria in children, and development of iron deficiency. AU - Harris,Paul R, AU - Serrano,Carolina A, AU - Villagrán,Andrea, AU - Walker,Marjorie M, AU - Thomson,Melanie, AU - Duarte,Ignacio, AU - Windle,Henry J, AU - Crabtree,Jean E, Y1 - 2012/12/25/ PY - 2012/12/27/entrez PY - 2012/12/27/pubmed PY - 2013/5/3/medline SP - 343 EP - 7 JF - Journal of clinical pathology JO - J Clin Pathol VL - 66 IS - 4 N2 - AIMS: Acute Helicobacter pylori infection is associated with transient hypochlorhydria. In H pylori-associated atrophy, hypochlorhydria has a role in iron deficiency (ID) through changes in the physiology of iron-complex absorption. The aims were to evaluate the association between H pylori-associated hypochlorhydria and ID in children. METHODS: Symptomatic children (n=123) were prospectively enrolled. Blood, gastric juice and gastric biopsies were taken, respectively, for haematological analyses, pH assessment and H pylori determination, and duodenal biopsies for exclusion of coeliac disease. Stool samples were collected for parasitology/microbiology. Thirteen children were excluded following parasitology and duodenal histopathology, and five due to impaired blood analysis. RESULTS: Ten children were hypochlorhydric (pH>4) and 33 were H pylori positive. In H pylori-positive children with pH>4 (n=6) serum iron and transferrin saturation levels % were significantly lower (p<0.01) than H pylori-positive children with pH≤4. No differences in ferritin, or total iron binding capacity, were observed. In H pylori-negative children with pH>4, iron and transferrin saturation were not significantly different from children with pH≤4. CONCLUSIONS: Low serum iron and transferrin in childhood H pylori infection is associated with hypochlorhydria. In uninfected children, hypochlorhydria was not associated with altered serum iron parameters, indicating a combination of H pylori infection and/or inflammation, and hypochlorhydria has a role in the aetiology of ID. Although H pylori-associated hypochlorhydria is transient during acute gastritis, this alters iron homeostasis with clinical impact in developing countries with a high H pylori prevalence. SN - 1472-4146 UR - https://www.unboundmedicine.com/medline/citation/23268321/Helicobacter_pylori_associated_hypochlorhydria_in_children_and_development_of_iron_deficiency_ L2 - https://jcp.bmj.com/lookup/pmidlookup?view=long&amp;pmid=23268321 DB - PRIME DP - Unbound Medicine ER -