In French Children, Primary Gastritis Is More Frequent Than Helicobacter pylori Gastritis

Abstract

The aim of this study was to analyze the histological characteristics according to the updated Sydney classification (intensity of gastritis, degree of activity, gastric atrophy, intestinal metaplasia, and Helicobacter pylori) in symptomatic children referred for upper gastrointestinal endoscopy. A 4-year retrospective descriptive study was carried out in 619 children (282 females and 337 males), median age 3.75 years (15 days to 17.3 years) referred for endoscopy. Six gastric biopsies were done (three antrum and three corpus) for histological analysis (n = 4), direct examination and H. pylori culture (n = 2). H. pylori status was considered positive if at least two out of three tests were positive and negative if all three tests were negative. The results showed that only 66 children (10.66%) were H. pylori positive. Histological antral and corpus gastritis was detected in, respectively, 53.95% and 59.12% of all cases, most of them of mild grade 1. Antral and corpus activity was grade 1 in 18.57% and 20.03% of cases. H. pylori-positive versus H. pylori-negative children did differ in terms of moderate and marked histological gastritis and grade 2 or 3 activities. One girl had moderate gastric atrophy and another one moderate intestinal metaplasia, both being H. pylori negative. The findings indicate that primary antrum and corpus gastritis is 5.3 and 6.9 times, respectively, more frequent than H. pylori gastritis in French children, with usually mild histological gastritis and activity. Gastric atrophy and intestinal metaplasia are rare.

Helicobacter pylori Infection and Childhood

“…Results from Kalach et al. were similar, showing a sensitivity of 87.5% and a specificity of 97.8%[31]. She et al.…”

“…Prell et al compared it to biopsy tests considered as reference in the setting of pre-and posteradication of H. pylori and found a sensitivity of 85.5-90.8% and a specificity of 91.0-97.6% [30]. Results from Kalach et al were similar, showing a sensitivity of 87.5% and a specificity of 97.8% [31]. She et al confirmed the lack of clinical utility of serology testing in children and adults, including an unacceptably low IgM sensitivity of just 6.8% [32].…”

Non-Helicobacter pylori Gastric Intestinal Metaplasia in Children: A Series of Cases and Review of the Literature

“…Treatment, long-term consequences, and surveillance protocols of GIM are not well established in the pediatric population. Contrary to our first case presented, a case report of a 15-year-old with GIM located inside the cryptic antral epithelium showed complete resolution following 3 months of PPI treatment [ 27 ]. In adults, as a pragmatic behavior, yearly endoscopic evaluation would appear justified in all GIM patients with at least one of these conditions: (1) IM extension > 20% mucosal involvement between endoscopies; (2) the presence of incomplete type IM; (3) first-degree relative of gastric cancer patients; and (4) smokers [ 24 ].…”

Effects of Chronic Gastritis on Sleep and Quality of Life in Adolescents

“…There are no accurate figures related to the precise incidence of gastritis in children. As for ulcer disease, H. pylori is probably no longer the major cause of gastritis in many parts of the world (5). In a prospective study of 100 children who underwent upper gastrointestinal system (GIS) endoscopy due to dyspeptic symptoms, 79% were found to have gastritis (none had ulcer disease), of whom only 33% had H. pylori infection (6).…”