title: Nodular gastritis: an endoscopic indicator of Helicobacter pylori infection in children.
abstract: BACKGROUND
  Helicobacter pylori (Hp) infection is a common and universally distributed bacterial infection. It is predominantly acquired in childhood.
  
  
  OBJECTIVE
  To assess the relationship between endoscopic nodular gastritis and Hp infection.
  
  
  METHODS
  A retrospective study was conducted in children who underwent upper gastrointestinal endoscopy for chronic abdominal pain. All children who had five gastric biopsies for histologic analysis, urease test and Hp culture were included in the study. The Sensitivity and sensibility of nodular gastritis were determined and different parameters were studied according the presence or not of nodular gastritis(age, gender, Hp status, gastritis score and lymphoid follicles).
  
  
  RESULTS
  49 children, mean age 6.9 ± 3 years (range 1-12 years) were eligible for the analysis. Hp Infection was diagnosed in 35 out of the 49 children (71.5 %). Nodular gastritis was recorded in 16 out of 49 children and in 14 infected children and 2 out of 14 non infected children (p=0.07), 40% sensitivity, 85.7% specificity, 87.5% positive predictive value, and 36,4% negative predictive value. The parameters associated significantly to the presence of nodular gastritis were older age: (p=0.04), Hp infection: (p=0.01), chronic gastritis: (p=0.05), active gastritis: (p=0.02), follicular gastritis: (p=0.005), higher gastritis score: (p=0.005). Completely normal gastric mucosal histology was never found in infected children with antral nodularity. Among all infected children, the gastritis score was significantly higher when there was a nodular gastritis and follicular gastritis was significantly associated to nodular gastritis.
  
  
  CONCLUSIONS
  The endoscopic pattern of antral nodularity identifies children with Hp infection, and active chronic follicular gastritis.
authors.affiliation: Department of Medicine C, Children Hospital, Tunis, Tunisia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Mazigh Mrad
authors.forename: Kamel
authors.initials: K
authors.lastname: Abidi
authors.forename: Ines
authors.initials: I
authors.lastname: Brini
authors.forename: Samir
authors.initials: S
authors.lastname: Boukthir
authors.forename: Azza
authors.initials: A
authors.lastname: Sammoud
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005756:Gastritis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology