From the Department of Pediatrics, Kaplan Medical Center, Rehovot, Israel.
Pediatric Gastroenterology Unit, Kaplan Medical Center, Rehovot, Israel.
Pediatr Infect Dis J. 2023 Oct 1;42(10):833-836. doi: 10.1097/INF.0000000000004012. Epub 2023 Jul 11.
Helicobacter pylori ( H. pylori ) gastritis may be an incidental finding during upper endoscopy performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD) and eosinophilic esophagitis (EoE). We aimed to describe the incidence of H. pylori in children undergoing endoscopy for CeD, IBD and EoE and determine the indications for treatment.
A retrospective, single-center study based on the review of endoscopy reports of pediatric patients, diagnosed with CeD, IBD and EoE, between January 2017 and December 2021. Data collected included; age, gender, hematologic parameters, endoscopic, histologic and H. pylori culture results, and information on eradication treatment.
H. pylori gastritis was diagnosed in 120 of 558 (21.5%) children [72 (60%) female, mean age 10.6 years] during gastroscopy performed for the diagnosis of other GI diseases. H. pylori was present in 87 of 404 (21.5%) CeD, 27 of 113 (23.9%) IBD and 6 of 41 (14.6%) EOE patients ( P = 0.46). The main indication for treatment was the presence of ulcers, in 4 of 120 (3.3%), and erosions in 17 of 120 (14.2%). Eradication treatment was recommended in 22 of 120 (18.3%) patients, 8 of 87 (9.2%) CeD, 10 of 27 (37%) IBD and 4 of 6 (66.7%) EoE patients, P < 0.001. Four independent positive treatment predictors were identified; age above 10 years {odds ratio (OR) = 10.57 [95% confidence interval (CI) 1.88-59.36], P = 0.007} the presence of nodular gastritis (OR = 5.03 [95% CI 1.09-23.15], P = 0.38), erosions [OR = 49.21 (95% CI 8.19-295.83), P < 0.000] and ulcers [OR = 22.69 (95% CI 1.25-410.22), P = 0.035]. CeD was a strong negative predictor for treatment [OR = 0.23 (95% CI 0.002-0.241), P = 0.002].
H. pylori gastritis is a common incidental finding during endoscopy. The indications for treatment are not well defined and should be further investigated.
在诊断乳糜泻（CeD）、炎症性肠病（IBD）和嗜酸性食管炎（EoE）时进行上消化道内镜检查，可能偶然发现幽门螺杆菌（H. pylori）胃炎。我们旨在描述在因 CeD、IBD 和 EoE 而行内镜检查的儿童中 H. pylori 的发生率，并确定治疗的指征。
这是一项基于 2017 年 1 月至 2021 年 12 月间进行的儿科患者内镜报告回顾的回顾性单中心研究，这些患者被诊断为 CeD、IBD 和 EoE。收集的数据包括：年龄、性别、血液学参数、内镜、组织学和 H. pylori 培养结果，以及根除治疗信息。
在因其他胃肠道疾病行胃镜检查的 558 名儿童中，有 120 名（21.5%）[72 名（60%）女性，平均年龄 10.6 岁]诊断为 H. pylori 胃炎。在 404 名 CeD 患者中，27 名（21.5%）、113 名 IBD 患者中 27 名（23.9%）和 41 名 EoE 患者中 6 名（14.6%）存在 H. pylori（P = 0.46）。治疗的主要指征是存在溃疡（4 名患者，3.3%）和糜烂（17 名患者，14.2%）。在 120 名患者中，建议进行根除治疗的有 22 名（18.3%），8 名 CeD 患者（9.2%）、10 名 IBD 患者（37%）和 4 名 EoE 患者（66.7%），P < 0.001。确定了四个独立的阳性治疗预测因素：年龄大于 10 岁（比值比[OR] = 10.57[95%置信区间（CI）1.88-59.36]，P = 0.007）、存在结节性胃炎（OR = 5.03[95%CI 1.09-23.15]，P = 0.38）、糜烂（OR = 49.21[95%CI 8.19-295.83]，P < 0.000）和溃疡（OR = 22.69[95%CI 1.25-410.22]，P = 0.035）。CeD 是治疗的强烈负预测因素（OR = 0.23[95%CI 0.002-0.241]，P = 0.002）。
H. pylori 胃炎是内镜检查时常见的偶然发现。治疗的指征尚未明确，需要进一步研究。
