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婴儿早期幽门螺杆菌感染所致萎缩性胃炎和慢性腹泻:一例报告

Atrophic gastritis and chronic diarrhea due to Helicobacter pylori infection in early infancy: A case report.

作者信息

Kakiuchi Toshihiko, Nakayama Aiko, Shimoda Ryo, Matsuo Muneaki

机构信息

Department of Pediatrics.

Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.

出版信息

Medicine (Baltimore). 2019 Nov;98(47):e17986. doi: 10.1097/MD.0000000000017986.

Abstract

RATIONALE

Helicobacter pylori infection causes atrophic gastritis in childhood, but atrophic gastritis due to H pylori infection is extremely rare in infancy. The relationship between H pylori infection and chronic diarrhea without protein leakage remains controversial.

PATIENT CONCERNS

An 8-month-old male infant presented to our hospital with severe watery diarrhea, erythema, and failure to thrive from approximately 1 month after birth. Blood, stool, esophagogastroduodenoscopy, total colonoscopy, and H pylori urease analysis results were positive, thereby suggesting atrophic gastritis.

DIAGNOSES

Atrophic gastritis and chronic diarrhea due to H pylori infection.

INTERVENTIONS

We performed H pylori eradication therapy using triple therapy with vonoprazan (6 mg/kg), amoxicillin (300 mg/d), and clarithromycin (120 mg/kg) for 7 days.

OUTCOMES

From approximately 1 week after the H pylori eradication therapy, the frequency of defecation had decreased, stool shape had improved, and body weight had gradually increased.

LESSONS

H pylori infection can cause atrophic gastritis and chronic diarrhea even in infancy. Early eradication therapy for H pylori infection may be useful for prevention of gastric cancer and improvement in growth disorders.

摘要

理论依据

幽门螺杆菌感染可导致儿童萎缩性胃炎,但幽门螺杆菌感染所致的萎缩性胃炎在婴儿期极为罕见。幽门螺杆菌感染与无蛋白渗漏的慢性腹泻之间的关系仍存在争议。

患者情况

一名8个月大的男婴自出生后约1个月起出现严重水样腹泻、红斑及生长发育迟缓,遂来我院就诊。血液、粪便、食管胃十二指肠镜检查、全结肠镜检查及幽门螺杆菌尿素酶分析结果均为阳性,提示萎缩性胃炎。

诊断

幽门螺杆菌感染所致萎缩性胃炎及慢性腹泻。

干预措施

我们采用沃克(6毫克/千克)、阿莫西林(300毫克/天)和克拉霉素(120毫克/千克)三联疗法进行幽门螺杆菌根除治疗,疗程7天。

结果

在幽门螺杆菌根除治疗后约1周,排便次数减少,大便形状改善,体重逐渐增加。

经验教训

幽门螺杆菌感染即使在婴儿期也可导致萎缩性胃炎和慢性腹泻。早期根除幽门螺杆菌感染治疗可能有助于预防胃癌及改善生长发育障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c15e/6882621/6f5450253601/medi-98-e17986-g001.jpg

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