Helicobacter pylori infection in children with celiac disease.
OBJECTIVE
To analyze the prevalence of Helicobacter pylori (H. pylori) infection in children with celiac disease (CD) and to examine the role of H. pylori infection in clinical, laboratory and histopathological presentations of CD.


METHODS
Data on 96 children with CD and 235 children who underwent endoscopy were compared for the prevalence and gastric histology pattern of H. pylori. Clinical presentation, laboratory and histological findings of CD children with and without H. pylori infection were compared.


RESULTS
Twenty-one subjects (21.8%) in the CD group and 56 subjects (23.8%) in the control group had H. pylori gastritis. Gastric metaplasia is higher in CD patients with H. pylori gastritis (19%) than in patients without H. pylori gastritis (1.3%) and in the control group (3.5%) (p<0.05 for all groups). Abdominal distension is more common at initial admission in CD patients with H. pylori gastritis (57.1% versus 14.6%, p<0.05). No significant difference was found between H. pylori (+) and (-) CD patients in terms of prevalence of anemia, iron deficiency and iron-deficiency anemia. Only mild duodenal histological findings were more common in H. pylori patients (57.1% versus 26.7%, p<0.05).


CONCLUSIONS
CD may be associated with H. pylori gastritis, but it does not affect the clinical presentation of the disease, except for abdominal distension; CD is associated with mild duodenal lesions. A gluten-free diet improves the symptoms in all patients independently of the presence of H. pylori gastritis. Gastric metaplasia increases in the presence of H. pylori gastritis. Further prospective studies are needed to examine the clinical and histopathological outcomes of gastric metaplasia associated with H. pylori gastritis in CD patients.
Aydogdu
Sema
S
Department of Pediatric Gastroenterology Hepatology and Nutrition, Ege University, Izmir, Turkey.
Cakir
Murat
M
Yuksekkaya
Hasan Ali
HA
Tumgor
Gokhan
G
Baran
Masallah
M
Arikan
Cigdem
C
Yagci
Rasit V
RV
D000293:Adolescent; D017677:Age Distribution; D001707:Biopsy, Needle; D016022:Case-Control Studies; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy / Q000379:methods; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012720:Severity of Illness Index; D017678:Sex Distribution; D014421:Turkey / Q000453:epidemiology