Evaluation of gastric histology in children and adolescents with Helicobacter pylori gastritis using the Update Sydney System.
BACKGROUND
Although Helicobacter pylori infection is prevalent in our country, there are few studies evaluating the associated histological abnormalities in children.


OBJECTIVE
To evaluate the histological features of the gastric mucosa in children and adolescents with Helicobacter pylori gastritis.


METHODS
One hundred and thirty two gastric biopsies from 22 symptomatic patients infected with H. pylori (14F/8M, median age 10 y 5 mo, age range 2 y 11 mo to 16 y 9 mo) were evaluated. Evaluated gastric regions included: antrum (lesser and greater curvature), corpus (lesser and greater curvature), incisura angularis and fundus. Histological examination was performed according to the Updated Sydney System, and regional scores for polymorphonuclear and mononuclear cell infiltrate as well as bacterial density were generated.


RESULTS
Fifteen (68.2%) patients presented H. pylori-chronic active gastritis, six (27.3%) presented antrum-predominant H. pylori-chronic active gastritis, and one (4.5%) presented corpus-predominant H. pylori-chronic active gastritis. Polymorphonuclear cell infiltrate and mononuclear cell infiltrate were observed in 93.9% and 98.5% of the biopsy specimens, respectively. Higher histological scores for polymorphonuclear infiltrate, mononuclear infiltrate, and bacterial density were observed in the gastric antrum. Intestinal metaplasia and gastric atrophy were not identified in any patient. Lymphoid aggregates and lymphoid follicles were observed in the gastric antrum of three (13.6%) and seven (31.8%) patients, respectively, but they were not related to antral nodularity.


CONCLUSIONS
Chronic active gastritis was observed in all patients with H. pylori infection. However, antral or corporeal predominance was not observed in most patients.
Pediatric Gastroenterology Division, Department of Pediatrics, Escola Paulista de Medicina, Universidade Federal de São Paulo / Escola Paulista de Medicina" (UNIFESP/EPM), São Paulo, SP, Brazil.
Marini
M
Langner
Rodrigo Strehl
RS
Machado
Francy R S
FR
Patrício
Elisabete
E
Kawakami
D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005756:Gastritis / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male