Histologic Study of Helicobacter pylori-Associated Gastritis in Children

Seo, Jeong Wan; Han, Woon Sup

Abstract

PURPOSE
The aim of the present study was to assess the clinical, endoscopic and histologic findings of the Helicobacter pylori(Hp)-associated gastritis in children.
METHODS
We have assessed 91 patient(age range 3-15 years) referred for upper intestinal endoscopy during 17 months. At least two antral biopsies were taken during endoscopy. The histological analysis and CLO test were done. The histologic changes were scored and semiquantitative assessment of the degree of Hp colonization was performed using Giemsa' stain.
RESULTS
1) Helicobacter pylori(Hp) was detected by CLO test and/or histologic analysis in 35 patients(38.5%). The CLO test was positive in 25 cases and H. pylori was colonized histologically in 10 patients. 2) The clinical symptoms were not significantly different between Hp positive and Hp negative patients(p>0.01). 3) Nodular antritis(37.1%) was a frequent endoscopic finding in Hp-infected patients, particularly in the subgroup with active chronic gastritis(93.8%). All patient with nodular antritis had Hp infection. 4) Helicobacter pylori has been associated both with active chronic gastritis(42.9%) and with nonactive chronic gastritis(40.0%). The common abnormal histologic finding was active chronic gastritis(42.9%) in Hp positive patients and nonactive chronic gastritis(66%) in HP negative patients. A significant correlation was found between Hp colonization score and the histologic categories(p<0.01). 5) The frequency of Hp infection(positiveness) as related to histologic categories was: active chronic gastritis 93.8 %; duodenal ulcer 66.7%; gastric ulcer 33.3 %; nonactive chronic gastritis 27.5%; normal 16.7%. 6) The histolgical colonization by Hp was assessed semiquantitatively, and a significantly greater Hp colonization score was observed in patients with signs of histological activity(p<0.01).
CONCLUSIONS
This study suggests that Hp infection was significantly associated with endoscopic nodular antritis and the presence of gastroduodenal pathology.