Endoscopic Nodular Gastritis in Dyspeptic Adults: Prevalence and Association with <i>Helicobacter pylori</i> Infection

Abstract

Objective: To determine the prevalence and histological features of endoscopic nodular gastritis (NG) in adult dyspeptic patients and its relation to Helicobacter pylori infection. Subjects and Methods: A retrospective endoscopic report review of 2,142 patients identified 67 patients with NG during the period from 1 September 2006 to 31 August 2007. A subset of 32 NG patients (group 1) who had had gastric biopsies during upper gastrointestinal endoscopy and had been evaluated for H. pylori infection were compared to 32 age- and gender-matched dyspeptic patients. They had undergone endoscopy during the same period, which yielded normal results, and had available biopsies that were similarly evaluated for H. pylori infection (controls, group 2). Pertinent clinical data were obtained from the patients’ records. An experienced pathologist assessed the biopsies for the presence and grade of inflammation, activity, glandular atrophy, intestinal metaplasia, presence and density of H. pylori and presence of lymphoid follicles or aggregates. Results: NG was identified in 67 (3.1%) patients. On histological examination, group 1 had a significantly higher grade of gastritis (p < 0.001). The presence and density of H. pylori infection was significantly higher in group 1 (p < 0.001). The H. pylori density correlated significantly with the severity of gastritis (r = 0.57, p < 0.001). The endoscopic performance of NG on H. pylori infection had high specificity (96.8%) and positive predictive value (93.3%). Conclusion: This study outlined the clinicopathological features of NG identified among a cohort of dyspeptic patients in Kuwait and confirmed the close association with H. pylori infection. However, our study has a limitation in that histopathologic assessment of all NG patients was not feasible.

Clinical Characteristics and the Expression Profiles of Inflammatory Cytokines/Cytokine Regulatory Factors in Asymptomatic Patients with Nodular Gastritis

“…In the present study, asymptomatic NG was frequent in young adults and females and was found in 2% of patients who received screening EGDs, in keeping with the results of Chen et al [10] and Al-Enezi et al [21]. However, it was previously observed that the prevalence of NG was variable and ranged from 0.05 to 66.3% in H. pylori-infected patients ( Table 6).…”

“…Recently, NG has also been reported in adult dyspeptic patients with H. pylori infection [3] and in patients with H. pylori-related diseases, such as gastroduodenal ulceration and gastric cancer [4,19,20]. As the clinical significance of NG comes to the fore, the clinicoepidemiological characteristics of NG in patients who underwent endoscopy for the evaluation of upper gastrointestinal symptoms have been revealed [3,6,9,10,21,22], and it has been recommended that symptomatic NG patients should receive H. pylori eradication treatment [5,6].…”

Prevalence ofHelicobacter pylorivirulence genotypes among children in Eastern Turkey

“…These isolates [by polymerase chain reaction (PCR)] were recovered from 101 Turkish children (53 girls and 48 boys, ranging between 4 and 18 years old, average 12 years) who underwent upper gastrointestinal endoscopy with abdominal symptoms at the clinic of the Pediatric Gastroenterology Department at the Firat University Hospital between March 2011 and September 2012. Antral nodularity was defined as being endoscopically characterized by the irregular appearance of the mucosa as like that of a "cobblestone pavement" [14] . Also, the presence of ulcers was determined by endoscopic examination.…”

Bacterial Load and Degree of Gastric Mucosal Inflammation in <i>Helicobacter pylori</i> Infection

“…The minimum of both H. pylori density and inflammatory changes was observed in the most distal part of the corpus at the greater curvature [23,24]. A positive correlation between high histological gastritis score and high density of H. pylori was also demonstrated in cases of nodular gastritis in adults as well as in children, where this typical endoscopic representation of disease is more common [25,26]. Marked CD4 (Th cell marker) and CD19 (B cell marker) positive inflammatory cell infiltration is concomitant in cases with a high histological grade of gastritis and high density of H. pylori, suggesting predominance of a humoral type immune response rather than a cytotoxic response.…”