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Objective. To establish the features of various clinical variants of chronic gastritis in childhood. Material and methods. 415 children aged 617 years with chronic Hp-associated gastritis were examined. The clinical and anamnestic data, the results of laboratory, endoscopic and morphological studies of gastrobioptates were analyzed. Genetic typing of Hp was carried out with the determination of 16 pathogenicity factors. The persistence of human herpes viruses of types 6 and 8 and Epstein Barr viruses in the gastric mucosa was determined. Results. The clinical heterogeneity of chronic gastritis in children with the allocation of four topical variants was established: isolated duodenitis, duodenogastritis, antrum gastritis, pangastritis. It was found that with the first two, a high frequency of giardiasis is registered, with antrumgastritis and especially pangastritis, a significant contamination of the gastric mucosa with Hp is detected, mainly of CagA and VacA-positive strains. It is proved that the persistence of the type 6 human herpes virus does not affect the severity of inflammation, while the presence of the Epstein-Barr virus increases it. Colonization of the gastric mucosa by highly pathogenic Hp strains significantly increases the severity and activity of inflammation. It is shown that atrophy of the gastric mucosa in children is uncertain, and true atrophic gastritis occurs only in 0.61 % of cases. Conclusions. Chronic gastritis in children is a heterogeneous pathology, and its individual variants differ significantly in etiological factors including infectious, pathogenetic mechanisms and features of the morphology of gastric mucosa. This should be taken into account when carrying out medical support for patients.
Objective. To establish the features of various clinical variants of chronic gastritis in childhood. Material and methods. 415 children aged 617 years with chronic Hp-associated gastritis were examined. The clinical and anamnestic data, the results of laboratory, endoscopic and morphological studies of gastrobioptates were analyzed. Genetic typing of Hp was carried out with the determination of 16 pathogenicity factors. The persistence of human herpes viruses of types 6 and 8 and Epstein Barr viruses in the gastric mucosa was determined. Results. The clinical heterogeneity of chronic gastritis in children with the allocation of four topical variants was established: isolated duodenitis, duodenogastritis, antrum gastritis, pangastritis. It was found that with the first two, a high frequency of giardiasis is registered, with antrumgastritis and especially pangastritis, a significant contamination of the gastric mucosa with Hp is detected, mainly of CagA and VacA-positive strains. It is proved that the persistence of the type 6 human herpes virus does not affect the severity of inflammation, while the presence of the Epstein-Barr virus increases it. Colonization of the gastric mucosa by highly pathogenic Hp strains significantly increases the severity and activity of inflammation. It is shown that atrophy of the gastric mucosa in children is uncertain, and true atrophic gastritis occurs only in 0.61 % of cases. Conclusions. Chronic gastritis in children is a heterogeneous pathology, and its individual variants differ significantly in etiological factors including infectious, pathogenetic mechanisms and features of the morphology of gastric mucosa. This should be taken into account when carrying out medical support for patients.
Objective. To establish the features of the cellular composition of gastric mucosa glands in chronic Hp-associated gastritis among children to improve its diagnostics. Material and methods. Morphometric analysis of fundal and pyloric gland cell populations was performed in 214 children aged 615 years with Hp-associated chronic gastritis. For this purpose, the number of main, parietal, endocrine and additional cells was calculated in the materials of gastrobiopsy of the gastric mucosa, the result was expressed in (per 1000 epithelial cells). Results. It was found that as the severity of inflammation in the fundal glands increases, the number of main cells decreases, the number of parietal, accessory and especially endocrine cells grows. In the pyloric glands, a reduction of the parietal pool, a decrease in the population of additional cells and a sharp increase in endocrinocytes is registered. With a decrease in the severity of inflammation, positive changes in the cellular composition of the glands are observed, but its full normalization does not occur 6 months after the course of antihelicobacter therapy. A significant proportion of patients, shows morphological signs of gastric mucosa atrophy, which is associated with inflammation and is uncertain. Its presence does not significantly affect the cellular composition of the gastric glands, and the regression of the inflammatory process is accompanied by a decrease in the degree of atrophy or complete disappearance of signs of the latter. Conclusions. The addition of a standard study of gastrobioptates with a quantitative morphometric analysis of the cellular composition of the fundal and pyloric glands in chronic gastritis among children objectifies the data of morphological assessment of pathohistological picture of gastric mucosa.
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