Hematological Extradigestive Manifestations of Helicobacter pylori Infection in Childhood

Abstract

Helicobacter pylori infects more than % of the world population and is acquired in infancy. Higher prevalence is found in developing countries, and within geographic areas the predominance correlates inversely with socioeconomic status, especially with living conditions during childhood. Initially, in adults, H. pylori was only associated with gastric diseases, such as peptic ulcer, gastritis, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue M"LT lymphoma, and in childhood, with chronic gastritis and duodenal ulcers in children. Recently, H. pylori has been related to non-gastric diseases, including hematological disorders such as iron deficiency anemia ID" , chronic idiopathic thrombocytopenia cITP , and vitamin " deficiency. H. pylori can trigger autoimmune atrophic gastritis and be responsible initially for an oral iron refractory anemia. Other hematological associations have been made, such as an increased risk of childhood leukemia in children of H. pylori-infected mothers and gastric bleeding in children with coagulation pathologies. H. pylori infection is important in the immune pathogenesis of chronic gastric inflammation and hematological diseases. The diagnostic methodology is based on non-invasive serology, C-urea breath test, stool HP antigen and invasive tests. The scientific community discussed and incorporated in international consensus for the investigation and management of these hematological extragastric pathologies ID", cITP, vitamin " deficiency, and M"LT lymphoma . In children, a similar attitude was obtained in all of these pathologies except for cITP, in which the investigation for H. pylori is not indicated.

Helicobacter pylori (H. pylori) Infection-Associated Anemia in the Asir Region, Saudi Arabia

“…H. pylori bacteria sequester and interfere with the iron absorption following the H. pylori-associated chronic gastritis [56] may lead to the lowering of Hb concentration in H. pylori-infected individuals. Moreover, hemorrhagic gastritis-dependent iron loss [57] and actively bleeding peptic ulceration may also contribute to depression in the Hb level of H. pylori-infected patients.…”

Evaluation of Hematological Parameters of Helicobacter pylori-Infected Adult Patients at Southern Ethiopia: A Comparative Cross-Sectional Study

“…Alteration of RBC parameters in H. pylori -infected adult patients associated with different mechanisms; consumption of iron by the H. pylori 30 decreased iron absorption secondary to chronic gastritis, 20 iron loss via hemorrhagic gastritis, and active bleeding peptic ulcers, deficiency of iron and vitamin B12 secondary to chronic and atrophic gastritis, 27 which might contribute to the alteration of RBC parameters in H. pylori -infected patients as compared to control.…”

“…This finding was in line with other similar studies conducted in Palestine in adult H. pylori -infected patients, 17 in Egypt 22 and Karachi. 38 Consumption of iron by the H. pylori , 30 decreased iron absorption secondary to chronic gastritis, 20 iron loss via hemorrhagic gastritis, and active bleeding peptic ulcers, 27 which might contribute to decrement of blood hemoglobin concentration in H. pylori -infected patients. Several studies reported that depletion of iron in H. pylori -infected patients, 30 and eradication of H. pylori infection shows improvements in blood hemoglobin concentration.…”

“… 26 Because most dietary iron is in the ferric form, needs acidic intra-gastric pH and ascorbic acid to reduce into ferrous form for absorption. 27 Hence, H. pylori is a major cause of chronic superficial gastritis leading to atrophy of gastric glands, resulting in reducing gastric acid secretion. 28 , 29 …”

The Burden and Risk Factors of Helicobacter Pylori Infection Among Government Employees Who Clinically Complain of Indigestion but Allergic Diseases in Southeastern Ethiopia: A Multi-Institution Cross-Sectional Study

“…It was discovered by two pathologists in 1982: Barry Marshall and Robin Warren, who were awarded a Nobel Prize in the indicated year. 1 H. pylori has been recognized as a major human pathogen for approximately four decades. 2 H. pylori infection is formally recognized as an infectious disease, an entity that is now included in the International Classification of Diseases 11th Revision.…”