title: Endoscopic and histological gastric lesions in children with celiac disease:  mucosal involvement is not only confined to the duodenum.
abstract: OBJECTIVE
  Lymphocytic gastritis (LG) has been reported in patients with celiac disease (CD). The aim of the present study was to evaluate gastric mucosa involvement in celiac children and gastroenterological controls (GC).
  
  
  METHODS
  In a retrospective study on 226 patients with CD (82  M; median age: 5.7 years) at diagnosis and 154 GC (66  M; median age: 7.4 years), the evaluation of gastric and duodenal mucosa was performed. CD was diagnosed according to the North America Society for Pediatric Gastroenterology, Hepatology, and Nutrition criteria. Gastric lesions were classified according to Updated Sydney System. Anti-gastric parietal cell antibodies (GPCA) were assayed by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  A total of 21.2% and 7% of patients with CD showed chronic superficial gastritis (CSG) and LG, respectively. Helicobacter pylori (Hp) infection was found in 6 (2.7%) children with CD (66.7% had CSG, 16.7% LG, and 16.7% interstitial gastritis). CSG was present in 21.4% of controls. No control subject showed LG. Hp infection was found in 24 (15.6%) children with GC (91.7% had CSG). Among patients with CSG, Hp infection was more frequent in controls than in celiac children (P < 0.0001). Ten of 90 patients with CD and 1 of 29 controls were positive for GPCA.
  
  
  CONCLUSIONS
  Gastritis is a common finding in children with CD and adolescents. In celiac subjects, CSG is the most frequently detected. Our data suggest the hypothesis that LG may be related to a longer exposure to gluten. The presence of GPCA may suggest the presence of an underlying autoimmune process.
authors: Department of Pediatrics, Sapienza University of Rome, Rome, Italy. raffaella.nenna@uniroma1.it
authors: Raffaella
authors: R
authors: Nenna
authors: Fabio Massimo
authors: FM
authors: Magliocca
authors: Claudio
authors: C
authors: Tiberti
authors: Gerarda
authors: G
authors: Mastrogiorgio
authors: Laura
authors: L
authors: Petrarca
authors: Maurizio
authors: M
authors: Mennini
authors: Federica
authors: F
authors: Lucantoni
authors: Rita Pia Lara
authors: RP
authors: Luparia
authors: Margherita
authors: M
authors: Bonamico
mesh_terms: D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004386:Duodenum / Q000473:pathology; D005260:Female; D005753:Gastric Mucosa / Q000276:immunology / Q000382:microbiology / Q000473:pathology*; D005756:Gastritis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D005983:Glutens / Q000276:immunology*; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D010295:Parietal Cells, Gastric / Q000276:immunology*; D015995:Prevalence; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000906:Antibodies; D005983:Glutens