Konno M, Muraoka S, Takahashi M, Imai T
Department of Pediatrics, Sapporo Kohsei General Hospital, Japan.
J Pediatr Gastroenterol Nutr. 2000 Jul;31(1):52-6. doi: 10.1097/00005176-200007000-00012.
Recent studies have suggested an association of Helicobacter pylori and iron-deficiency anemia (IDA). This is a report of six cases of IDA associated with H. pylori gastritis.
Six patients with IDA were studied (5 boys and 1 girl; mean age 13.6 years; range 13-15 years). Five had a medical history of long-standing IDA and of oral iron supplementation at outpatient clinics. The anemia recurred after the iron therapy had been discontinued. The sixth patient was admitted to the hospital with severe IDA. An extensive work-up was ordered that included technetium-99m (99mTc) scans for Meckel's diverticulum, total colonoscopy, and gastrointestinal endoscopy. After biopsy-based H. pylori test results were confirmed to be positive, anti-H. pylori therapy consisting of lansoprazole, clarithromycin, and metronidazole was administered for 2 weeks with no iron supplementation. The hematologic profile and iron status were assessed periodically after the end of the eradication regimen.
Upper gastrointestinal endoscopy revealed a marked antral nodularity but no evidence of bleeding lesions in all the patients. Given the histology and the fact that rapid urease test results were positive, chronic active gastritis with H. pylori was diagnosed in all these cases. H. pylori was successfully eradicated in all the patients. There was no evidence of IDA in any of the follow-up examinations between 27 and 50 months after anti-H. pylori therapy.
H. pylori infection may be involved in cases of IDA of unknown origin, and the eradication of H. pylori can be associated with the resolution of anemia.
近期研究表明幽门螺杆菌与缺铁性贫血（IDA）之间存在关联。本文报告6例与幽门螺杆菌胃炎相关的IDA病例。
对6例IDA患者进行研究（5例男孩，1例女孩；平均年龄13.6岁；年龄范围13 - 15岁）。5例患者有长期IDA病史且在门诊接受过口服铁剂补充治疗。铁剂治疗中断后贫血复发。第6例患者因严重IDA入院。进行了全面检查，包括99m锝（99mTc）扫描以排查梅克尔憩室、全结肠镜检查及胃肠道内镜检查。在基于活检的幽门螺杆菌检测结果被确认为阳性后，给予由兰索拉唑、克拉霉素和甲硝唑组成的抗幽门螺杆菌治疗2周，期间不补充铁剂。根除治疗方案结束后定期评估血液学指标和铁状态。
上消化道内镜检查显示所有患者胃窦部有明显结节，但无出血性病变迹象。鉴于组织学检查结果及快速尿素酶试验呈阳性，所有病例均诊断为幽门螺杆菌相关性慢性活动性胃炎。所有患者的幽门螺杆菌均被成功根除。在抗幽门螺杆菌治疗后27至50个月的任何一次随访检查中，均未发现IDA迹象。
幽门螺杆菌感染可能与不明原因的IDA病例有关，根除幽门螺杆菌可能使贫血得到缓解。
