Department of Pediatric Gastroenterology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
Department of Pathology, Ministry of Health, Ankara City Hospital, Ankara, Turkey.
Helicobacter. 2020 Oct;25(5):e12716. doi: 10.1111/hel.12716. Epub 2020 Jun 26.
Autoimmune atrophic gastritis (AIG) is very rare in children. Despite a better understanding of histopathologic changes and serological markers in this disease, underlying etiopathogenic mechanisms and the effect of Helicobacter pylori (H pylori) infection are not well known. We aimed to investigate the relation between AIG and H pylori infection in children.
We evaluated the presence of AIG and H pylori infection in fifty-three patients with positive antiparietal cell antibody (APCA). Demographic data, clinical symptoms, laboratory and endoscopic findings, histopathology, and presence of H pylori were recorded.
The children were aged between 5 and 18 years, and 28 (52.8%) of them were male. Mean age was 14.7 ± 2.6 years (median: 15.3; min-max: 5.2-18), and 10 (18.8%) of them had AIG confirmed by histopathology. In the AIG group, the duration of vitamin B12 deficiency was longer (P = .022), hemoglobin levels were lower (P = .018), and APCA (P = .039) and gastrin (P = .002) levels were higher than those in the non-AIG group. Endoscopic findings were similar between the two groups. Intestinal metaplasia was higher (P = .018) in the AIG group. None of the patients in the AIG group had H pylori infection (P = .004). One patient in the AIG group had enterochromaffin-like cell hyperplasia.
Our results show that, in children, H pylori infection may not play a role in AIG. AIG could be associated with vitamin B12 deficiency, iron deficiency, and APCA positivity in children. APCA and gastrin levels should be investigated for the early diagnosis of AIG and intestinal metaplasia.
儿童自身免疫性萎缩性胃炎（AIG）非常罕见。尽管人们对这种疾病的组织病理学变化和血清标志物有了更好的了解，但潜在的病因发病机制和幽门螺杆菌（H pylori）感染的影响尚不清楚。我们旨在研究儿童 AIG 与 H pylori 感染之间的关系。
我们评估了 53 例抗壁细胞抗体（APCA）阳性患者中 AIG 和 H pylori 感染的存在情况。记录了人口统计学数据、临床症状、实验室和内镜检查结果、组织病理学以及 H pylori 的存在情况。
患儿年龄为 5 至 18 岁，其中 28 名（52.8%）为男性。平均年龄为 14.7±2.6 岁（中位数：15.3；最小-最大值：5.2-18），其中 10 名（18.8%）经组织病理学证实患有 AIG。在 AIG 组中，维生素 B12 缺乏的持续时间更长（P=0.022），血红蛋白水平更低（P=0.018），APCA（P=0.039）和胃泌素（P=0.002）水平更高，而非 AIG 组。两组内镜检查结果相似。AIG 组肠上皮化生更高（P=0.018）。AIG 组无一例患者存在 H pylori 感染（P=0.004）。AIG 组中有 1 例患者存在肠嗜铬样细胞增生。
我们的结果表明，在儿童中，H pylori 感染可能不是 AIG 的原因。AIG 可能与儿童维生素 B12 缺乏、缺铁和 APCA 阳性有关。应检测 APCA 和胃泌素水平，以早期诊断 AIG 和肠上皮化生。
