Aydogdu Sema, Cakir Murat, Yuksekkaya Hasan Ali, Tumgor Gokhan, Baran Masallah, Arikan Cigdem, Yagci Rasit V
Department of Pediatric Gastroenterology Hepatology and Nutrition, Ege University, Izmir, Turkey.
Scand J Gastroenterol. 2008;43(9):1088-93. doi: 10.1080/00365520802101846.
To analyze the prevalence of Helicobacter pylori (H. pylori) infection in children with celiac disease (CD) and to examine the role of H. pylori infection in clinical, laboratory and histopathological presentations of CD.
Data on 96 children with CD and 235 children who underwent endoscopy were compared for the prevalence and gastric histology pattern of H. pylori. Clinical presentation, laboratory and histological findings of CD children with and without H. pylori infection were compared.
Twenty-one subjects (21.8%) in the CD group and 56 subjects (23.8%) in the control group had H. pylori gastritis. Gastric metaplasia is higher in CD patients with H. pylori gastritis (19%) than in patients without H. pylori gastritis (1.3%) and in the control group (3.5%) (p<0.05 for all groups). Abdominal distension is more common at initial admission in CD patients with H. pylori gastritis (57.1% versus 14.6%, p<0.05). No significant difference was found between H. pylori (+) and (-) CD patients in terms of prevalence of anemia, iron deficiency and iron-deficiency anemia. Only mild duodenal histological findings were more common in H. pylori patients (57.1% versus 26.7%, p<0.05).
CD may be associated with H. pylori gastritis, but it does not affect the clinical presentation of the disease, except for abdominal distension; CD is associated with mild duodenal lesions. A gluten-free diet improves the symptoms in all patients independently of the presence of H. pylori gastritis. Gastric metaplasia increases in the presence of H. pylori gastritis. Further prospective studies are needed to examine the clinical and histopathological outcomes of gastric metaplasia associated with H. pylori gastritis in CD patients.
分析乳糜泻（CD）患儿幽门螺杆菌（H. pylori）感染的患病率，并探讨H. pylori感染在CD临床、实验室及组织病理学表现中的作用。
比较了96例CD患儿和235例接受内镜检查患儿的H. pylori患病率及胃组织学模式。比较了有和无H. pylori感染的CD患儿的临床表现、实验室及组织学检查结果。
CD组21例（21.8%）和对照组56例（23.8%）有H. pylori胃炎。有H. pylori胃炎的CD患者胃化生（19%）高于无H. pylori胃炎的患者（1.3%）及对照组（3.5%）（所有组p<0.05）。有H. pylori胃炎的CD患者初次入院时腹胀更常见（57.1%对14.6%，p<0.05）。H. pylori（+）和（-）的CD患者在贫血、缺铁及缺铁性贫血患病率方面无显著差异。仅轻度十二指肠组织学表现在H. pylori患者中更常见（57.1%对26.7%，p<0.05）。
CD可能与H. pylori胃炎有关，但除腹胀外不影响疾病的临床表现；CD与轻度十二指肠病变有关。无麸质饮食可改善所有患者的症状，与是否存在H. pylori胃炎无关。H. pylori胃炎时胃化生增加。需要进一步的前瞻性研究来检查CD患者中与H. pylori胃炎相关的胃化生的临床及组织病理学结局。
