Lymphoid follicles in children with Helicobacter pylori-negative gastritis.

Published on Aug 11, 2017in Clinical and Experimental Gastroenterology
· DOI :10.2147/CEG.S133421
Efrat Broide24
Estimated H-index: 24
,
Vered Richter3
Estimated H-index: 3
+ 4 AuthorsHaim Shirin9
Estimated H-index: 9
(TAU: Tel Aviv University)
Sources
Abstract
PURPOSE: The prevalence of Helicobacter pylori gastritis has been declining, whereas H. pylori-negative gastritis has become more common. We evaluated chronic gastritis in children with regard to H. pylori status and celiac disease (CD). PATIENTS AND METHODS: Demographic, clinical, endoscopic, and histologic features of children who underwent elective esophagogastroduodenoscopy were reviewed retrospectively. Gastric biopsies from the antrum and corpus of the stomach were graded using the Updated Sydney System. H. pylori presence was defined by hematoxylin and eosin, Giemsa, or immunohistochemical staining and urease testing. RESULTS: A total of 184 children (61.9% female) met the study criteria with a mean age of 10 years. A total of 122 (66.3%) patients had chronic gastritis; 74 (60.7%) were H. pylori-negative. Children with H. pylori-negative gastritis were younger (p=0.003), were less likely to present with abdominal pain (p=0.02), and were mostly of non-Arabic origin (p=0.011). Nodular gastritis was found to be less prevalent in H. pylori-negative gastritis (6.8%) compared with H. pylori-positive gastritis (35.4%, p<0.001). The grade of mononuclear infiltrates and neutrophil density was more severe in the H. pylori-positive group (p<0.001). Pan-gastritis and lymphoid follicles were associated most commonly with H. pylori. Although less typical, lymphoid follicles were demonstrated in 51.3% of H. pylori-negative patients. The presence or absence of CD was not associated with histologic findings in H. pylori-negative gastritis. CONCLUSION: Our findings suggest that lymphoid follicles are a feature of H. pylori-negative gastritis in children independent of their CD status.
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Background & Aims Eradication of Helicobacter pylori infection has been reported to reduce the risk of gastric cancer among asymptomatic individuals in high-risk areas. The magnitude of benefit of H pylori eradication in populations with different levels of gastric cancer risk and in different clinical scenarios is unclear. We performed a systematic review and meta-analysis of randomized controlled trials and observational studies to investigate the effects of H pylori eradication on the inciden...
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Objective To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis. Design Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels wer...
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Gastric cancer (GC) continues to be an important health threat as the third leading cause of cancer related death in both sexes worldwide. In a recent analysis, the mortality trends for the time period from 1980 till 2011 were significantly downward in all countries, but the declines in the USA, EU and several other major countries were of low magnitude when compared with the past. Furthermore, the relative contribution of cardia cancers compared with noncardia cancers increased among countries ...
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Aims The aim of the study was to determine the topographic prevalence of lymphoid follicles, lymphoid aggregates, gastric glandular atrophy and intestinal metaplasia among children with chronic abdominal pain. The association between these lesions and age, type of gastritis and Helicobacter pylori density was also assessed. Methods A total of 358 patients (mean age: 10, 18 ± 3, 26 years; male : female ratio: 0.92) with chronic abdominal pain who had upper gastrointestinal endoscopy were included...
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#2Arturo Luévano-González (MCW: Medical College of Wisconsin)H-Index: 1
Last. Alexander C. Mackinnon (MCW: Medical College of Wisconsin)H-Index: 18
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Abstract Chronic inflammation and infection are major risk factors for gastric carcinogenesis in adults. As chronic gastritis is common in Mexican children, diagnosis of Helicobacter pylori and other causes of gastritis are critical for the identification of children who would benefit from closer surveillance. Antral biopsies from 82 Mexican children (mean age, 8.3±4.8 years) with chronic gastritis (36 H pylori +, 46 H pylori −) were examined for gastritis activity, atrophy, intestinal metaplasi...
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The prevalence of celiac disease (CD) has increased in recent decades without a clear explanation. The “hygiene hypothesis” theorizes that decreased exposure to bacterial antigens may trigger autoimmunity. We aimed to determine whether Helicobacter pylori infection and CD were associated among patients undergoing upper gastrointestinal endoscopy. We performed a cross-sectional study of patients who underwent esophagogastroduodenoscopy with submission of gastric and duodenal biopsies to Miraca Li...
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#1Bram Flahou (UGent: Ghent University)H-Index: 21
#2Freddy Haesebrouck (UGent: Ghent University)H-Index: 101
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A substantial number of reports published in the last year have contributed to a better understanding of both human and animal infection with non-Helicobacter pylori Helicobacter species (NHPH). Gastric infection of humans with Helicobacter suis and Helicobacter felis as well as unidentified NHPH has been described to cause a chronic gastritis and a variety of clinical symptoms, whereas enterohepatic NHPH, including Helicobacter cinaedi, Helicobacter bilis, and Helicobacter canis, have been repo...
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Cited By2
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#1Hala El-ZimaityH-Index: 13
#2Won-Tak Choi (UCSF: University of California, San Francisco)H-Index: 16
Last. Robert H. Riddell (MSH: Mount Sinai Hospital, Toronto)H-Index: 18
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Gastric biopsies are often submitted with as clinical question Helicobacter pylori (HP) infection. Regularly, the morphology suggests a HP infection but the organism is not detected in special stains. This review presents a practical approach to deal with such biopsies. The first step is to exclude a false negative result of the search for HP, by ensuring that both antral and oxyntic mucosa are present, by the use of sensitive stains, identification of marked reactive changes, such as intestinal...
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#1Michal Kori (Kaplan Medical Center)H-Index: 11
#2Ilva Daugule (LU: University of Latvia)H-Index: 10
Last. Vaidotas Urbonas (Vilnius University)H-Index: 8
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: Helicobacter pylori infection in children differs from infection in adults in many aspects. The rate of infection, epidemiology, clinical presentations and complications, the applicability of diagnostic tests, antibiotic resistance, treatment options, and success rates differ significantly. Due to all these differences, management guidelines for children and adults differ also substantially. In 2017, the Updated ESPGHAN and NASPGHAN Guidelines on the management of H. pylori infection in childr...
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