title: Atrophic gastritis: Helicobacter pylori versus duodenogastric reflux.
abstract: OBJECTIVE
  The objective of this study was to asses the prevalence of atrophic gastritis in children. We also wanted to compare the clinical manifestation, endoscopic appearance and the degree of the gastric atrophy in children and to identify the possible causes which determine gastric atrophy.
  
  
  METHODS
  We evaluated 247 children with chronic gastritis (153 female/94 male, mean age 12.32 years). Atrophy was defined as the loss of normal glandular components, including replacement with fibrosis and/or intestinal metaplasia.
  
  
  RESULTS
  The prevalence of the atrophic gastritis was 16.6% (41 cases), mean age 11.59+/-1.75 years, male-to-female ratio 16:25. The clinical manifestations were correlated with the patient age (infants and toddlers were evaluated mostly for weight loss - 4 cases, and older children for abdominal pain - 22 cases). The endoscopic appearance was described as either nodular (15 cases), or erythematous gastritis (10 cases), or normal (10 cases). According to the Sydney System, the degree of atrophy was found to be mild in 3 patients, moderate in 25, and severe in 13 patients; 14 cases were associated with duodenogastric reflux, 5 with Helicobacter pylori and 2 with Helicobacter heilmannii infection, but in 17 cases the etiology was unknown.
  
  
  CONCLUSIONS
  Atrophic gastritis is present in childhood, even at very young ages (infants, toddlers). The endoscopic appearance is not characteristic for the presence of atrophy. The degree of the atrophy is not correlated with the age of the children. Because of the relatively high number of duodenogastric reflux associated with gastric atrophy, further studies need to evaluate the potential causes and clinical course.
authors.affiliation: Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Kinga Cristina
authors.initials: KC
authors.lastname: Slăvescu
authors.affiliation: Second Pediatric Clinic, Children's Hospital, Cluj-Napoca, Romania.
authors.forename: Camelia
authors.initials: C
authors.lastname: Mărgescu
authors.affiliation: Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Second Pediatric Clinic, Children's Hospital, Cluj-Napoca, Romania.
authors.forename: Alexandru
authors.initials: A
authors.lastname: Pîrvan
authors.affiliation: Second Pediatric Clinic, Children's Hospital, Cluj-Napoca, Romania.
authors.forename: Costică
authors.initials: C
authors.lastname: Şarban
authors.affiliation: Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania ; Second Pediatric Clinic, Children's Hospital, Cluj-Napoca, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Gheban
authors.affiliation: Second Pediatric Clinic, Children's Hospital, Cluj-Napoca, Romania.
authors.forename: Nicolae
authors.initials: N
authors.lastname: Miu
keywords: Helicobacter pylori; atrophic gastritis; duodenogastric biliary reflux