Refractory iron deficiency anemia and Helicobacter Pylori Infection in pediatrics: A review.
BACKGROUND
Since the discovery of Helicobacter pylori, several clinical reports have demonstrated that H. Pylori infection has emerged as a new cause of refractory iron stores in children. We carried out a systematic literature review to primarily evaluate the existing evidence on the association between childhood H. Pylori infection and iron deficiency anemia (IDA) and secondly, to investigate the beneficial effects of bacterium elimination.


METHODS
This review concerns important pediatric studies published from January 1991 to October 2014. Fourteen case reports and series of cases, 24 observational epidemiologic studies, seven uncontrolled trials, and 16 randomized clinical trials were included in the review.


RESULTS
Although there are a few observational epidemiologic studies and some randomized trials mostly due to the potential confounders, most studies reported a positive association linking between H. Pylori infection and iron deficiency or iron deficiency anemia among children. In addition, it seems that elimination of H. Pylori infection induces beneficial effects on iron deficiency.


CONCLUSIONS
Since the evidence for the association of H. pylori eradication therapy and refractory childhood IDA is not enough and there are contrasting data about such association, future high quality and cohort researches are needed to determine the causal association.
Associate Professor of Pediatric Gastroenterology, Maternal and Childhood Obesity research Center, Urmia University of Medical Sciences, Shahid Motahari Hospital, Urmia, Iran. drgheibi@umsu.ac.ir.
Sh
Sh
Gheibi
Associate Professor of Maternal and Child Health, Reproductive Health Research Center, Urmia University of Medical Sciences. Urmia, I.R. Iran. hamidfarrokh@umsu.ac.ir.
H R
HR
Farrokh-Eslamlou
Assistant Professor of Pediatric Hematology and Oncology, Department of Pediatric. Urmia University of Medical Sciences, I.R. Iran.
M
M
Noroozi
Emergency medicine resident, Department of Emergency Medicine, Arak University of Medical Sciences , I.R Iran.
A
A
Pakniyat
Helicobacter Pylori Infection; Iron deficiency anemia; pediatrics