Helicobacter pylori and iron deficiency anaemia in children.
BACKGROUND
Both iron deficiency anaemia and Helicobacter pylori infection are rare in developed countries. A possible connection has been suggested between these two diseases and our aim was to define the clinical picture and to study the effect of bacterial eradication in H. pylori colonized children with severe anaemia.


METHODS
Eight children with iron deficiency anaemia refractory to iron supplementation were examined with gastroscopy because of suspicion of H. pylori infection. Anaemia was treated with oral ferrous sulphate. Two patients needed blood transfusions. Eradication therapy was given either with combination of colloidal bismuth subcitrate and metronidazole or with omeprazole, clarithromycin and amoxycillin. Eradication was confirmed by urea breath test 4 weeks post-treatment.


RESULTS
H. pylori infection was confirmed histologically and microbiologically in all children, who also presented with chronic, active gastritis. Bacteria were successfully eradicated in 7/8 patients. Correction of haemoglobin values was observed post-treatment, iron stores still being deficient at control in 4/8 children.


CONCLUSIONS
Our results suggest that H. pylori might have a role in causing iron deficiency anaemia in school-age children. Screening for H. pylori should be extended to cover those patients with other clinical manifestations than symptoms from gastrointestinal tract.
Ashorn
M
M
Dept. of Pediatrics, Tampere University Hospital, Finland. merja.ashorn@uta.fi
Ruuska
T
T
Mäkipernaa
A
A
D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use*; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D002648:Child; D002908:Chronic Disease; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005756:Gastritis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D016480:Helicobacter pylori; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use*; D009853:Omeprazole / Q000627:therapeutic use*; D009942:Organometallic Compounds / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors; D014508:Urea
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D006454:Hemoglobins; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D008795:Metronidazole; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate; D009853:Omeprazole