Clinical and histological features of duodenal ulcer in children and adolescents

Kawakami, Elisabete; Machado, Rodrigo Strehl; Fonseca, Jacqueline A.; Patricio, Francy R.

doi:10.2223/jped.1207

Cited by 5 publications

(6 citation statements)

References 19 publications

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“…This figure is surprising, since we recently reported a series of duodenal ulcer cases with 95.3% of the patients with H pylori (5) . However, other ulcer cases have to be taken into account, such as use of anti-inflammatory drugs and non-H pylori related ulcer disease (3) .…”

Section: Discussionmentioning

confidence: 89%

Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children

Kawakami

Machado

Ogata

et al. 2008

Arq. Gastroenterol.

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-Background -Decreasing prevalence of H pylori infection has been reported in some countries. Aim -To evaluate the prevalence of Helicobacter pylori infection in a 10-year period in children submitted to upper digestive endoscopy. Methods -It was a retrospective observational study. The records of 1,165 endoscopies performed during a 10-year period in a public hospital of the City of São Paulo, SP, Brazil, in patients up to 18-year-old. Only the first endoscopy was considered. Helicobacter pylori infection was defined by the rapid urease test, performed with one fragment of antral mucosa. Chi-square for trend has been estimated to compare Helicobacter pylori prevalence across the period. Results -The main indication for endoscopy was epigastric pain (47.4%). There were 392 patients with H pylori infection (33.6%), 12.8% being infants, 19.4% toddlers, 28.8% schoolchildren and 46.3% adolescents. Prevalence was 60.47% in the first year of the study and 30.43% in the last. Among the less than 6-year-old patients there was a decrease in infection prevalence from 25% for the 1993-6 period to 14.3% in the 2000-02 period, while among the over 12-year-old patients the decrease was from 55.5% in the first period to 39.6% in the latter. The decrease in H pylori infection prevalence was more intense within patients with epigastric pain, in which prevalence has decreased from 48.2% (92/191) in 1993-6, to 41.9% (65/155) in 1997-9 and 27.7% (57/206) in 2000-02. Conclusion -The study suggests a significant decrease in the prevalence of H pylori infection regarding the studied patients. The trend was mainly observed in the younger age group and in patients with epigastric pain.

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Section: Discussionmentioning

confidence: 89%

Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children

Kawakami

Machado

Ogata

et al. 2008

Arq. Gastroenterol.

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“…The low prevalence of DU in childhood, ranging from four to six new cases per year, or 1:2500 paediatric admissions in large paediatric centres [29,30], including this service [31], means that this problem is difficult to solve, but it was minimised as much as possible by analysing the data with rank tests for small samples.…”

Section: Discussionmentioning

confidence: 99%

Differences in peripheral blood lymphocyte phenotypes between Helicobacter pylori-positive children and adults with duodenal ulcer

Soares

Rocha

et al. 2007

Clinical Microbiology and Infection

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The immunological mechanisms involved in the development of duodenal ulcer, especially in childhood, are unclear. Helicobacter pylori-positive children and adults, with and without duodenal ulcer, were therefore compared with respect to CD4(+) T-cells, and CD8(+) T-cells, B-cells and B1a-cells, as well as cell activation (CD4(+)/HLA-DR(+) and CD8(+)/HLA-DR(+)) and co-stimulatory (CD4(+)/CD28(+) and CD8(+)/CD28(+)) markers, in peripheral blood. Children with and without duodenal ulcer differed significantly. In particular, there was a phenotypic change in CD8(+) T-cells from children with ulcer that involved a 200% increase in the number of CD8(+)/HLA-DR(+) cells/mm(3) and a decrease of 34.2% in the number of CD8(+)/CD28(+) cells/mm(3). This phenotype of chronically activated memory CD8(+) T-cells, which has also been observed in patients with AIDS and tuberculosis, is associated with disease severity and progression. A lower frequency of B1a-cells was also observed in the group of children with ulcer. Conversely, no difference between infected adults with and without ulcer was observed, but the percentage of CD4(+)/HLA-DR(+) cells was lower in adults with ulcer, suggesting that a down-regulated immune response may play a role in the development of duodenal ulcer in adults. Gastric inflammation correlated positively with CD4(+) and chronically activated CD4(+) T-cells in children and adults without duodenal ulcer, respectively. These results suggest that there are differences in the immunophenotyping profile between H. pylori-positive children and adults with duodenal ulcer, indicating the possibility of distinct immune mechanisms in the development of the disease according to age.

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“…Several studies [5]- [10] have showed that abdominal pains are the most frequent indications of UGIE in children in African countries with frequencies ranging from 22% to 90%. Moreover, the identification of Helicobacter pylori (H. pylori) as a major cause of chronic gastritis and peptic ulcer in children highlights the important diagnosis of UGIE in CAP [11] [12] [13].…”

Section: Introductionmentioning

confidence: 99%

Upper Gastrointestinal Endoscopy in Children’s Abdominal Pains in Ivory Coast

Bangoura¹,

Kissi-Kacou²,

Fanou³

et al. 2016

OJGas

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Since a longtime considered as functional and psychological, children's abdominal pains (CAP) is a public health problem. Advances in digestive endoscopy and Helicobacter pylori (H. pylori) discovery have reignited the debate of the organicity of CAP. The aim of this study is to determine the diagnosis rentability of upper gastrointestinal endoscopy (UGIE) in CAP in Ivory Coast. Patients and Methods: This a retrospective analytical study based on reports of UGIE performed in 2 university hospital and 3 private clinics of Abidjan from march 2007 to march 2016. The children (from 1 day to 15 years) in which UGIE were performed for abdominal pains were included in the study. Results: 116 UGIE were performed in children for abdominal pains during the study period. Epigastric pain was the main indication of UGIE (88%). The diagnosis rentability of UGIE was more than 70% in this study. The main anomalies observed in UGIE were gastropathies. Ulcers were rarely found. Conclusion: UGIE play an important diagnosis role in CAP in Ivory Coast. However gastric biopsies for Helicobacter pylori research are not common practice in our country.

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Clinical and histological features of duodenal ulcer in children and adolescents

Cited by 5 publications

References 19 publications

Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children

Decrease in prevalence of Helicobacter pylori infection during a 10-year period in Brazilian children

Differences in peripheral blood lymphocyte phenotypes between Helicobacter pylori-positive children and adults with duodenal ulcer

Upper Gastrointestinal Endoscopy in Children’s Abdominal Pains in Ivory Coast

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