Lymphocytic Gastritis and Celiac Disease in Indian Children: Evidence of a Positive Relation

Prasad, Kaushal Kishor; Thapa, Babu Ram; Lal, Sadhna; Sharma, Arun; Nain, C. K.; Singh, Kartar

doi:10.1097/mpg.0b013e31816232a7

Cited by 20 publications

(20 citation statements)

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“…The underlying mechanisms of iron-deficiency anemia could be the chronic erosive gastritis, the decreased iron absorption secondary to chronic gastritis and the iron utilization by Hp (25). The frequent histological gastric involvement in our series confirms previous study showing that gluten intolerance may involve other portions of the gastrointestinal tract (6)(7)(8)(9)(10)(11)(12). The most frequent form was the chronic superficial gastritis both in children and in adults which was present in almost all CD patients with Hp infection but the CSG was found also in one third of CD patients without Hp infection, thus suggesting that the pathogenesis of gastric damage in CD may be affected by other factors, possibly including the delay of gastric emptying, which is reported in 30-60% of celiac (24).…”

Section: Discussionsupporting

confidence: 89%

“…The demonstration of histological changes of the small bowel mucosa, evaluated according to Marsh classification as modified by Oberhuber et al (5), is the gold standard for CD diagnosis. Increasing evidence supports that the intestinal damage in celiac disease is not confined to the duodenum, but covers other tracts such as the stomach (6)(7)(8)(9)(10)(11)(12). Helicobacter pylori (Hp) infection is the most prevalent gastrointestinal infection world-wide and it represents the main cause of chronic gastritis, peptic ulcer disease and gastric malignancies (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Gastric pathology in celiac children and adults: the role of helicobacter pylori

Pontone¹

2013

P.& R.

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Background: celiac disease (CD) is an immune-mediated enteropathy that occurs in genetically susceptible individuals and is caused by an abnormal immune response to gluten. A possible relationship between Helicobacter pylori (Hp) infection and CD is not fully understood.Objectives: the aim of our study was to compare the prevalence of Hp infection and gastric findings in CD children as compared to CD adults. Methods: in our retrospective study 61 children (38 females; age range 1-16.8 years; median age: 7.1 years) and 60 adults (43 females; age range 18-74 years; median age: 35.5 years) with CD were evaluated. 65 children and 74 adults were chosen as control group age and sex matched. Diagnosis of Hp infection was based on positivity to histology and rapid urea test. Baseline clinical and demographic data analysis was performed with the chi-square test and the type of correlation was determined by determining the Pearson correlation coefficient. Data were compared across groups, using either χ 2 tests (for categorical variables) to test statistical significance. Nominal, a two-tailed probability (p) value were used and were considered to be statistically significant if p<0.05. Results: all celiac enrolled were positive for EMA and/or tTG antibodies. Hp infection was diagnosed in two children and ten adults (3.3% vs 17.5%; p<0.02). Hp infection was less frequent in celiac patients compared to the control groups, in both children and adults (p=0.005 and p=0.4, respectively). The gastric involvement in celiac patients without Hp infection was more frequent both in children (66.1% vs 11.8%; p<0.0001) and in adults (22.5% vs 16%, p=0.3) with respect to Hp-negative controls. Discussion and Conclusion: in conclusion, in our study we confirmed that the stomach can be involved in celiac disease both in children and adults. Sometimes, Hp infection coexists with CD diagnosis, particularly in celiac adults that can present some specific clinical findings.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Gastric pathology in celiac children and adults: the role of helicobacter pylori

Pontone¹

2013

P.& R.

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“…The Maastricht III Consensus Report [40] also recommends a treatment for weeks with triple eradication therapy, irrespective of the geographical region, which would ultimately results in the complete resolution of gastritis. However, studies in the Indian population have found that rate of eradication of H. pylori using this triple therapy for one week has been lower than those reported in the West [35, 41]. Troxipide may aid in the improvement of this eradication rate, either as a monotherapy or in combination with other currently used agents.…”

Section: Discussionmentioning

confidence: 96%

“…It is also striking that while the presence of H. pylori in the Indian population is substantial [32, 33], only 3.5% (5/142) of the study sample showed positive serology for H. pylori. The literature search for a few Indian studies also revealed very low incidence of 5.8%–17.7% of H. pylori infection among the patients showing the endoscopic presence of gastritis [34, 35]. In the earlier studies, the presence of H. pylori in the study population has generally been confirmed by subjecting the biopsy sample to the rapid urease test, in addition to either serology or the urease breath test [36, 37].…”

Section: Discussionmentioning

confidence: 99%

Troxipide in the Management of Gastritis: A Randomized Comparative Trial in General Practice

Dewan¹,

Balasubramanian²

2010

Gastroenterology Research and Practice

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Background. A trial of empirical acid-suppressive therapy is the usual practice for most patients with symptoms of gastritis in primary care. Aim. To assess the relative efficacy of Troxipide and Ranitidine in patients with endoscopic gastritis over a four-week period. Methods. In all, 142 patients were randomized to Troxipide (100 mg tid) or Ranitidine (150 mg bid) for a period of four weeks. The severity of the signs of endoscopic gastritis at baseline and week 4 using a four-point scale and the subjective symptom severity at baseline and week 2 & week 4 using a Visual analog scale (VAS) were documented. Results. Troxipide was found to be superior to Ranitidine for both, the complete resolution and improvement of endoscopic gastritis. Higher proportion of patients showed complete healing of erosions (88.14%), oozing (96.77%), and edema (93.88%) with Troxipide as compared to Ranitidine (P < .01). Patients receiving Troxipide also showed a greater improvement in the VAS scores for abdominal pain, bloating, and heartburn (P < .01). Both the drugs were found to be well tolerated. Conclusion. In patients with endoscopic gastritis, Troxipide, with its superior rate of improvement, resolution of signs, and subjective clinical symptoms, can be considered as an alternative to the commonly used antisecretory agents.

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“…Lymphocytic gastritis (LG), the first described in 1986, is a rare histopathologic subtype of chronic gastritis [ 1 , 2 ]. It is found less than about 1.5% in gastric mucosa biopsy specimens of chronic gastritis [ 1 , 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pyloriAssociated Lymphocytic Gastritis in a Child

Kim

Eom

Park

2014

Pediatr Gastroenterol Hepatol Nutr

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Lymphocytic gastritis (LG) is a rare subtype of chronic gastritis. It is defined as dense proliferation of intraepithelial lymphocytes (IELs) more than 25 lymphocytes per 100 epithelial cells. The known major causes of LG are celiac disease and Helicobacter pylori infection. H. pylori associated LG (HpLG) has more enhanced cytotoxic and apoptotic tendencies than chronic H. pylori gastritis. A 12-year-old girl with postprandial epigastric pain was diagnosed HpLG on endoscopic biopsy. After the 1st eradication therapy, H. pylori bacilli were still found, and urea breathing test was positive. Although the endoscopic finding was partially improved, clinical symptoms and histologic finding were persisted. We could achieve the improvement of clinical symptoms and disappearance of IELs after the 2nd eradication. The discordant of histopathologic and endoscopic improvement occurred after the 1st eradication therapy of HpLG. Therefore the clinical and histopathologic evaluation should be considered as well as endoscopic findings.

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Lymphocytic Gastritis and Celiac Disease in Indian Children: Evidence of a Positive Relation

Abstract: This study supports a pathogenetic relation between CD and LG. CD without LG also showed increased gastric intraepithelial lymphocytes. H pylori infection may be another cause of LG in children.

Cited by 20 publications

References 34 publications

Gastric pathology in celiac children and adults: the role of helicobacter pylori

Gastric pathology in celiac children and adults: the role of helicobacter pylori

Troxipide in the Management of Gastritis: A Randomized Comparative Trial in General Practice

Helicobacter pyloriAssociated Lymphocytic Gastritis in a Child

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