Helicobacter pylori in children with peptic ulcer and their families

Oderda, Giuseppina; Vaira, Dino; Holton, John; Ainley, Colin; Altare, Frédéric; Boero, M; Smith, Anthony; Ansaldi, N

doi:10.1007/bf01297021

Cited by 97 publications

(54 citation statements)

References 18 publications

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“…Previous investigations using serological or histological diagnosis and/or the [ 13 C]urea breath test have demonstrated an intrafamilial clustering of H. pylori infections in Canada (8), the United States (18), Italy (7,27), and England (1,26). It has also been suggested that H. pylori is transmitted from infected parents, especially infected mothers, to children in Germany (4,28,29), the United States (10), and Japan (20,22).…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori Intrafamilial Infections: Change in Source of Infection of a Child from Father to Mother after Eradication Therapy

Taneike

Tamura

Shimizu

et al. 2001

Clin Diagn Lab Immunol

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Biopsy specimens of the antrum and corpus were obtained from four Helicobacter pylori-infected members of a family and from the same boy (son 1) in whom the infection reappeared after simultaneous successful eradication treatment of three family members, excluding the mother. A total of 18 to 60 H. pylori isolates were obtained from each specimen and subjected to rRNA gene restriction pattern analysis. The father's isolates and the initial isolates from son 1 showed the same HindIII type, which was divided into three HaeIII subtypes. Isolates from the mother and a brother (son 2) and posttreatment isolates from son 1 showed a distinct HindIII type (with one minor subtype), which was divided into six HaeIII subtypes. All subtypes of the initial isolates from son 1 were present in the father's isolates, and all subtypes of the posttreatment isolates from son 1 were present in the mother's isolates but not in son 2's. Electron microscopic analysis of the biopsy specimens demonstrated extremely high levels of H. pylori colonization in the father's gastric mucosa. H. pylori adherence with a ruffle formation was also demonstrated. The findings suggest that son 1 was infected initially with the H. pylori strain of the father and son 2 was infected with the H. pylori strain of the mother and that after eradication therapy son 1 was reinfected with the H. pylori strain of the mother, who did not undergo eradication therapy.Helicobacter pylori colonizes the gastric mucosa via an oral route, and around 60% of individuals worldwide are infected with H. pylori (5). Children are at high risk for H. pylori infections (21, 34). H. pylori infection may persist for years or be lifelong (30,35), although spontaneous clearance is also common in childhood (15,19). H. pylori infection is closely associated with gastritis and peptic ulcers (14, 25), and it is also a bacterial risk factor for gastric cancer (16) and mucosa-associated lymphoid tissue lymphoma (2).The precise mechanisms of H. pylori transmission are not yet known. Previous investigations by Drumm et al. in 1990 (8), Malaty et al. in 1991 (18), and Oderda et al. in 1991 (27) suggested intrafamilial clustering of H. pylori infections. Molecular DNA analyses of familial strains of H. pylori were then performed by Nwokolo et al. in 1992 (26) and by Bamford et al. in 1993 (1), demonstrating intrafamilial infections due to a single H. pylori strain (or a common source of infection within the family). Now, transmission among family members is considered to constitute the main route of H. pylori infection (6).In intrafamilial H. pylori infection, the infected parents, particularly infected mothers, have been considered likely to play a key role in the transmission of H. pylori (4, 28). In contrast, in developing countries, environmental factors may be more important than intrafamilial transmission (29, 32).Those epidemiological studies, however, are not based on molecular biological analysis of H. pylori strains. In this study, we investigated the molecular basis of H. pylor...

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori Intrafamilial Infections: Change in Source of Infection of a Child from Father to Mother after Eradication Therapy

Taneike

Tamura

Shimizu

et al. 2001

Clin Diagn Lab Immunol

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“…Quando são excluídos os casos com úlcera relacionados a drogas antiinflamatórias, o H. pylori é detectado em quase todos os ulcerosos. Cinqüenta e cinco a 100% das crianças com úlcera duodenal e cerca de 40% daquelas com úlcera gástrica são infectadas 8,[19][20][21] . Das 76 crianças com úlcera duodenal por nós investigadas 69 tinham úlcera duodenal primária e, dentre elas, 83% e 91%, respectivamente, eram H. pylori positivas.…”

Section: Fatores Ambientaisunclassified

Peptic Ulcer

Carvalho¹

2000

J Pediatr (Rio J)

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Objective: To present a current review about pathogenesis, pathophysiology, diagnosis and treatment of peptic ulcer disease in children, based on a review of the literature and the author's personal experience. Methods:We reviewed the most relevant articles about peptic ulcers in children published during the last twenty years. Results:The gastroduodenal peptic ulcer is very common in adults, mostly in the developing countries. Although it is less frequent in children, optical fibroendoscopy has increased the number of diagnosed cases. The peptic ulcer is classified by its etiology as primary and secondary. Secondary peptic ulcer is related to an underlying disease or use of drugs, while the primary ulcer happens in the absence of underlying systemic diseases. The primary duodenal ulcer is the most common presentation, and there are strong evidences of H. pylori involvement in the etiology. Clinical presentation changes with age and ulcer type. Secondary ulcers are mostly acute and sometimes dramatic, while the primary ones have a chronic evolution mostly similar to patients with functional recurrent abdominal pain, but the presence of epigastric pain, feedingrelated pain, vomiting, bleeding, familiar history of peptic ulcer, nocturnal pain, and male gender are strongly related to peptic ulcer. The acid antisecretory agents have great efficacy on relieving symptoms and solving ulcerate lesion, although H. pylori eradication itself prevents primary duodenal ulcer recurrence. Conclusions:Many factors are involved in the etiopathogenesis of primary peptic ulcer, with H. pylori being the most important. Although there is no single ideal therapeutic protocol as yet, antibiotics now play an important role in peptic ulcer treatment, and laboratory tests for H. pylori are an essential part of accurate diagnosis and treatment.J. pediatr. (Rio J.). 2000; 76 (Supl.2): S127-S134: peptic ulcer, gastric ulcer, duodenal ulcer, H. pylori. ResumoObjetivo: Apresentar uma revisão da patogênese, da fisiopatologia, do diagnóstico e do tratamento da úlcera péptica em pediatria, baseada em revisão da literatura e na experiência da autora.Métodos: Foram revisadas as publicações mais relevantes sobre o assunto, publicadas na literatura médica nos últimos 20 anos.Resultados: A úlcera péptica gastroduodenal é muito comum em adultos, principalmente nos países em desenvolvimento. Embora seja bem menos freqüente na faixa pediátrica, com o advento da fibroendoscopia óptica, tem havido um maior número de casos diagnosticados. Ela é classificada quanto à localização (gástrica, duodenal) e à provável causa em primária e secundária. A úlcera secundária é associada a uma doença subjacente ou ao uso de medicamentos, enquanto a úlcera primária ocorre na ausência de doenças sistêmicas. A úlcera duodenal primária é a forma mais freqüente e há fortes evidências do envolvimento do H. pylori na sua etiopatogênese. A apresentação clínica varia com a idade e o tipo de úlcera. As úlceras secundárias têm sintomatologia aguda e, às vezes, dramática, e...

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“…6 Peptic ulcers also occur in H. pylori-negative patients, especially those receiving nonsteroidal anti-inflammatory drugs (nSaids), as shown in other studies. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] in a previous uncontrolled study, 1 we assessed the frequency of gastro-duodenal ulcers/erosions in dyspeptic children referred for upper gastrointestinal (gi) endoscopy in 14 european countries. ulcers and/or erosions were observed in 56 of 694 children (8.1%).…”

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Helicobacter pylori Infection in European Children with Gastro-duodenal Ulcers and Erosions

Bontems

Kalach

Vanderpas

et al. 2013

Pediatric Infectious Disease Journal

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Background: to analyze risk factors associated with gastro-duodenal ulcers and erosions in children. Methods: Open, prospective, multicenter, case-control study carried out in 11 european countries in patients with gastric or duodenal ulcers/erosions and 2 age-matched controls each. Possible risk factors were recorded. logistic regression models were performed with adjustment for centers and age groups. Results: Seven-hundred thirty-two patients (244 cases, 153 with erosions only and 91 with ulcers, and 488 controls) were recruited. Children receiving antimicrobials or acid suppressive drugs before endoscopy were excluded (202 cases/390 controls remained for risk factor analysis). Helicobacter pylori was detected more frequently in cases than controls but only in 32.0% versus 20.1% in controls (P = 0.001). independent exposure factors for gastric ulcers were male gender (P = 0.001), chronic neurologic disease (P = 0.015), chronic renal disease (P < 0.001) and nonsteroidal anti-inflammatory drug consumption (P = 0.035). exposure factors for duodenal ulcers were H. pylori infection (P < 0.001) and steroid consumption (P = 0.031). Chronic renal disease was the only independent factor associated with gastric erosions (P = 0.026), those associated with duodenal erosions being H. pylori infection (P = 0.023), active smoking (P = 0.006) and chronic arthritis (P = 0.008). no risk factor was identified in 97/202 (48.0%) cases. Conclusions: H. pylori remains a risk factor for duodenal, but not for gastric lesions in children in countries with low prevalence of infection. no risk factor could be identified in half of the children with gastro-duodenal ulcers/erosions.

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Helicobacter pylori in children with peptic ulcer and their families

Cited by 97 publications

References 18 publications

Helicobacter pylori Intrafamilial Infections: Change in Source of Infection of a Child from Father to Mother after Eradication Therapy

Helicobacter pylori Intrafamilial Infections: Change in Source of Infection of a Child from Father to Mother after Eradication Therapy

Peptic Ulcer

Helicobacter pylori Infection in European Children with Gastro-duodenal Ulcers and Erosions

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