title: [Chronic gastritis in children].
abstract: BACKGROUND
  Active gastritis, atrophic gastritis (AG) and intestinal metaplasia are lesions associated with Helicobacter pylori (H. pylori) infection in adults.
  
  
  OBJECTIVE
  To assess the prevalence of chronic gastritis, its histological characteristics and clinical features in children.
  
  
  METHODS
  345 children (M/F: 151/194, mean age: 8.6 +/- 3.7 years; range: 1-18 years) were enrolled, referred for upper gastrointestinal endoscopy (UGI endo) with clinical manifestations of gastritis, i.e., recurrent abdominal pain (n = 232, 67.2%), upper gastrointestinal bleeding (n = 59, 17.1%) and miscellaneous (n = 53, 15.3%). Four perendoscopic gastric biopsy specimens (antrum: 2, fundus: 2) were taken. Biopsies were assessed and graded according to the updated Sydney system. H. pylori infection was considered if 2 out 3 tests were positive (culture, histology and rapid urease test), whereas 3 concordant negative results identified H. pylori negative children.
  
  
  RESULTS
  H. pylori infection and chronic gastritis were detected in 215/345 (62.3%) (M/F: 104/117, sex ratio M/F = 0.89) and 221/345 (64.05%) children, respectively. Recurrent abdominal pain (n = 149, 67.4%) was the main clinical features of chronic gastritis followed by vomiting (n = 43, 19.5%) and upper gastrointestinal bleeding (n = 41, 18.6%). Any clinical features were however found to be specific. UGI endo showed; nodular gastritis (n = 90, 40.72%), congestive gastritis (n = 84, 38%), gastric ulcer (n = 9), bulbar ulcer (n = 5) and normal (n = 47, 21.2%). Chronic gastritis was active in 115 cases (52%) and was significantly associated with nodular gastritis (p < 0.05). Thirty two chronic gastritis (14.4%) exhibited AG (M/F: 16/16, mean age: 9.4 +/- 3.4 years) and 30/32 (93.7%) were H. pylori positive. AG was significantly associated with H. pylori infection (p < 0.0001) and nodular gastritis (p < 0.005). Active, follicular and AG were significantly associated with H. pylori infection (p < 0.00001). Three patients exhibited intestinal metaplasia.
  
  
  CONCLUSIONS
  Chronic gastritis is frequent in children. Any clinical features were found to be specific. It significantly associated H. pylori infection and nodular gastritis. Atrophic gastritis was found in 14.5% of children.
authors.affiliation: Service de Médecine Infantile C, Hôpital d'Enfants de Tunis.
authors.forename: Samir
authors.initials: S
authors.lastname: Boukthir
authors.forename: Faten
authors.initials: F
authors.lastname: Aouididi
authors.forename: Sonia
authors.initials: S
authors.lastname: Mazigh Mrad
authors.forename: Ilhem
authors.initials: I
authors.lastname: Fetni
authors.forename: Olfa
authors.initials: O
authors.lastname: Bouyahya
authors.forename: Lamia
authors.initials: L
authors.lastname: Gharsallah
authors.forename: Azza
authors.initials: A
authors.lastname: Sammoud
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005756:Gastritis / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence