Antral nodularity identifies children infected with Helicobacter pylori with higher grades of gastric inflammation.
BACKGROUND
The endoscopic pattern of antral nodularity is a peculiar finding in children with Helicobacter pylori infection. The aim of this study was to determine whether this finding is related to more severe gastritis.


METHODS
One hundred seventy-four consecutive children (median age 8.7 years) referred for gastroscopy were studied. Biopsy specimens from the antrum and body of the stomach were taken to assess H pylori status, gastritis score, and lymphoid follicles. Clinical diagnosis, major symptoms and endoscopic findings were recorded.


RESULTS
Eighty-four (48%) children (median age 10.5 years) had evidence of H pylori infection. The endoscopic pattern of antral nodularity was found only in children infected with H pylori (34/84, 40.5% vs. 0/90, 0%, p < 0.0001% 100% specificity, 40.5% sensitivity). Among all children infected with H pylori, the gastritis score was higher (p < 0.0001) in those with antral nodularity (n = 34) than in those without (n = 50). Completely normal gastric mucosal histology was never found in children infected with H pylori with antral nodularity. The presence and number of lymphoid follicles was strongly related to the finding of antral nodularity (p < 0.01).


CONCLUSIONS
The endoscopic pattern of antral nodularity identifies children with H pylori infection, severe gastritis, and increased lymphoid follicles.
Luzza
F
F
Dipartimento di Medicina Sperimentale e Clinica, Cattedra di Pediatria, Università di Catanzaro Magna Graecia, Catanzaro, Italy.
Pensabene
L
L
Imeneo
M
M
Mancuso
M
M
Contaldo
A
A
Giancotti
L
L
La Vecchia
A M
AM
Costa
M C
MC
Strisciuglio
P
P
Docimo
C
C
Pallone
F
F
Guandalini
S
S
D001706:Biopsy; D002648:Child; D005260:Female; D005756:Gastritis / Q000382:microbiology* / Q000473:pathology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D011706:Pyloric Antrum / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index