在上消化道内镜检查中发现幽门螺杆菌感染用于诊断乳糜泻、炎症性肠病和嗜酸性食管炎：一项多中心儿科欧洲研究。

Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study.

机构信息

Université Libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.

Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology, University of Messina, Messina, Italy.

出版信息

Helicobacter. 2024 May-Jun;29(3):e13092. doi: 10.1111/hel.13092.

DOI:10.1111/hel.13092

PMID:38790089

Abstract

BACKGROUND

Helicobacter pylori may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of H. pylori in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment.

MATERIALS AND METHODS

A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021.

DATA COLLECTED

age, gender, hematologic parameters, endoscopic, histologic, and H. pylori culture results, and information on eradication treatment.

RESULTS

H. pylori was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1-14.6)]. H. pylori was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (p = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31-10.1) p < 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62-11.47, p < 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33-3.81, p 0.003]. Treatment rates were higher in centers with a low H. pylori prevalence (<20%) [OR 3.36 95% CI 1.47-7.66 p 0.004].

CONCLUSIONS

Identifying H. pylori incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.

摘要

背景

在进行上消化道内镜检查（UGE）以诊断乳糜泻（CeD）、炎症性肠病（IBD）和嗜酸性食管炎（EoE）时，可能会发现幽门螺杆菌。我们旨在描述在进行 UGE 以诊断 CeD、IBD 和 EoE 的儿童中 H. pylori 的频率，以及接受根除治疗的儿童人数。

材料和方法

本回顾性多中心研究来自 14 个国家，包括 2019 年 1 月至 2021 年 12 月期间被诊断为 CeD、IBD 和 EoE 的儿科患者。

数据收集

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。

结果

在 3890 名儿童中发现 349 名（9%）儿童有 H. pylori [167 名（48%）男性，中位数年龄 12 岁（四分位间距 8.1-14.6）]。在 10%（173/1733）CeD、8.5%（110/1292）IBD 和 7.6%（66/865）EoE 患者中存在 H. pylori（p=NS）。在欧洲（东欧 5.2%（28/536）、南欧 3.8%（78/2032）、西欧 5.6%（28/513））和中东地区（中东 26.6%（215/809）之间，患病率差异有统计学意义[比值比（OR）7.96，95%置信区间（CI）（6.31-10.1），p<0.0001]。在 349 名患者中有 131 名（37.5%）接受了根除治疗，34.6% CeD、35.8% IBD 和 56.1% EoE。推荐治疗的预测因素包括糜烂/溃疡[OR 6.45，95%CI 3.62-11.47，p<0.0001]和结节性胃炎[OR 2.25，95%CI 1.33-3.81，p 0.003]。在 H. pylori 患病率较低（<20%）的中心，治疗率更高[OR 3.36，95%CI 1.47-7.66，p 0.004]。