title: Correlation of clinical, endoscopic, and histological findings with virulence factors in children with Helicobacter pylori gastritis.
abstract: OBJECTIVE
  As there are limited data regarding the correlation between virulence factors and clinical, endoscopic, and histological findings in children with Helicobacter pylori gastritis, we aimed to evaluate that probable relationship in pediatric cases.
  
  
  METHODS
  One hundred and fifty-nine children with chronic abdominal pain or dyspepsia were included in this study. Upper gastrointestinal endoscopy was performed and multiple biopsy samples were taken from the esophagus, the antrum, and the duodenum. PCR was used for the determination of virulence factors.
  
  
  RESULTS
  According to PCR analysis, 98 (61.6%) children were positive for H. pylori. Using histopathological examination and culture, H. pylori was detected in 65 (40.9%) and 51 (32.1%) children, respectively. Peptic ulcer prevalence and histopathological features were not different among cagA, cagE, or iceA1 positive and negative groups (P>0.05). Peptic ulcer prevalence and histopathological findings were more common in iceA2-positive patients (P<0.05). Antral nodularity was more common in cagA-positive patients (P<0.05). Endoscopic and histological features were not different among patients with or without m1 or m2 strains (P>0.05). S1b positivity was associated with a higher esophagitis rate (P<0.05).
  
  
  CONCLUSIONS
  Among virulence factors, iceA2 was associated with peptic ulcer and milder histopathological findings, and vacAs1 was associated with milder histopathological findings.
authors.affiliation: aDepartment of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition Departments of bClinical Microbiology cPublic Health dPathology, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Mukadder A
authors.initials: MA
authors.lastname: Selimoglu
authors.forename: Hamza
authors.initials: H
authors.lastname: Karabiber
authors.forename: Baris
authors.initials: B
authors.lastname: Otlu
authors.forename: Ozge
authors.initials: O
authors.lastname: Yildirim
authors.forename: Ali
authors.initials: A
authors.lastname: Özer
authors.forename: Emine
authors.initials: E
authors.lastname: Samdanci
mesh_terms: D015746:Abdominal Pain / Q000382:microbiology / Q000473:pathology; D000293:Adolescent; D001426:Bacterial Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004381:Duodenal Ulcer / Q000382:microbiology; D004415:Dyspepsia / Q000382:microbiology / Q000473:pathology; D004941:Esophagitis / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000382:microbiology* / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D011706:Pyloric Antrum / Q000473:pathology; D013276:Stomach Ulcer / Q000382:microbiology; D014774:Virulence / Q000235:genetics; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; C408644:IceA2 protein, Helicobacter pylori; C074689:VacA protein, Helicobacter pylori; D037521:Virulence Factors