The Resolution of Severe Iron-Deficiency Anemia After Successful Eradication of Helicobacter pylori in Teenagers

Kato, Seiichi; Gold, Benjamin D.; Kato, Ayumu

doi:10.1097/pg9.0000000000000238

Cited by 2 publications

(5 citation statements)

References 25 publications

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“…The level of anemia in gastritis is not dependent on the presence of Helicobacter [14]. However, in a study by S. Kato et al, it was shown that hemoglobin, serum iron, and ferritin values significantly increased 2-3 months after eradication therapy [15,16].…”

Section: Types Of Gastritis and Clinical Manifestationsmentioning

confidence: 94%

Chronic gastritis in pediatrics

Gabueva,

Kalinchuk,

Radchenko

et al. 2023

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Chronic gastritis is one of the most common diseases of the gastrointestinal tract. High rates of gastritis in children are associated with poor nutrition, physical inactivity, drug abuse, bad habits, a number of concomitant diseases, immune disorders, allergization of the body, and stress. Although a significant proportion in the structure of chronic gastritis is occupied by gastritis associated with Helicobacter pylori infection, many clinical forms are diagnosed that are not associated with the presence of a microbial pathogen in the gastric mucosa. The goal is to highlight the problem of chronic gastritis in children, including risk factors, etiology, clinical manifestations, diagnosis and treatment. Materials and methods. To achieve these goals, a literature search was carried out in the PubMed and Google Scholar databases. The search depth did not exceed 5 years. Uninformative and duplicate articles were excluded. The final list of references included 42 articles. Results. In addition to traditional risk factors for adults, the incidence of chronic gastritis in children is influenced by artificial feeding, pathology of pregnancy and childbirth, respiratory infections, decreased mobility, and concomitant pathology. Helicobacter pylori infection is detected in 56% of children referred to a gastroenterologist for gastrointestinal symptoms. Manifestations of gastritis vary from asymptomatic to epigastric pain with dyspeptic symptoms. Conclusion. 1) Currently, up to 30-40% of children suffer from chronic gastritis. 2) Triple therapy regimens are traditionally used to eradicate Helicobacter pylori, but quadruple therapy is used in populations with high resistance to antimicrobial drugs. 3) In the treatment of eosinophilic gastritis, the drugs benralizumab and vedolizumab demonstrate high effectiveness, leading to depletion of the pool of eosinophils in the blood and tissues of the stomach, as well as clinical improvement. 4) Effective treatment for collagen gastritis has not yet been developed. The treatment regimen includes an elimination diet, proton pump inhibitors, and iron supplements.

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Section: Types Of Gastritis and Clinical Manifestationsmentioning

confidence: 94%

Chronic gastritis in pediatrics

Gabueva,

Kalinchuk,

Radchenko

et al. 2023

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“…Eradication of H. pylori results in reversal of long-standing IDA [28,29]. Furthermore, successful eradication of H. pylori leads to long-term resolution of refractory or recurrent IDA in Japanese teenagers [27]. Taking together the cumulative evidence described above, it is concluded that H. pylori causality on childhood IDA has been established.…”

Section: Clinical Evidencementioning

confidence: 94%

“…In one study of twins with H. pylori infection [89], it was suggested that host genetic factors are important in the development of ID or IDA. In a recent study [27], one sibling case with recurrent H. pyloriassociated IDA showed long-term resolution after successful eradication therapy.…”

Section: Host Genetic Factorsmentioning

confidence: 95%

“…In a pediatric multi-center study in Japan [33], it is suggested that blood loss from the gastrointestinal tract rarely causes IDA in children with H. pylori infection. Children with H. pyloriassociated IDA often have no endoscopic hemorrhagic lesions and negative results for fecal occult blood tests using ant-hemoglobin antibodies [27,34]. Blood loss from the gastrointestinal mucosa does not appear to be the primary pathogenetic cause of H. pyloriassociated IDA /ID in Alaska native children.…”

Section: Gastrointestinal Mucosal Lesions and Idamentioning

confidence: 99%

“…Recent studies have reported that H. pylori-associated IDA is frequently refractory to iron-supplementation therapy or shows recurrent episodes of the IDA once supplementation has been discontinued [25,26]. Such refractory or recurrent natures of H. pyloriassociated IDA can be resolved by eradication of the bacteria [23,25,27]. Eradication of H. pylori results in reversal of long-standing IDA [28,29].…”

Section: Clinical Evidencementioning

confidence: 99%

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Helicobacter pylori-Associated Iron Deficiency Anemia in Childhood and Adolescence-Pathogenesis and Clinical Management Strategy

Kato¹,

Gold

Kato

2022

JCM

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Many epidemiological studies and meta-analyses show that persistent Helicobacter pylori infection in the gastric mucosa can lead to iron deficiency or iron deficiency anemia (IDA), particularly in certain populations of children and adolescents. Moreover, it has been demonstrated that H. pylori infection can lead to and be closely associated with recurrent and/or refractory iron deficiency and IDA. However, the pathogenesis and specific risk factors leading to this clinical outcome in H. pylori-infected children remain poorly understood. In general, most of pediatric patients with H. pylori-associated IDA do not show evidence of overt blood loss due to gastrointestinal hemorrhagic lesions. In adult populations, H. pylori atrophic gastritis is reported to cause impaired iron absorption due to impaired gastric acid secretion, which, subsequently, results in IDA. However, significant gastric atrophy, and the resultant substantial reduction in gastric acid secretion, has not been shown in H. pylori-infected children. Recently, it has been hypothesized that competition between H. pylori and humans for iron availability in the upper gastrointestinal tract could lead to IDA. Many genes, including those encoding major outer membrane proteins (OMPs), are known to be involved in iron-uptake mechanisms in H. pylori. Recent studies have been published that describe H. pylori virulence factors, including specific OMP genes that may be associated with the pathogenesis of IDA. Daily iron demand substantively increases in children as they begin pubertal development starting with the associated growth spurt, and this important physiological mechanism may play a synergistic role for the microorganisms as a host pathogenetic factor of IDA. Like in the most recent pediatric guidelines, a test-and-treat strategy in H. pylori infection should be considered, especially for children and adolescents in whom IDA is recurrent or refractory to iron supplementation and other definitive causes have not been identified. This review will focus on providing the evidence that supports a clear biological plausibility for H. pylori infection and iron deficiency, as well as IDA.

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The Resolution of Severe Iron-Deficiency Anemia After Successful Eradication of Helicobacter pylori in Teenagers

Cited by 2 publications

References 25 publications

Chronic gastritis in pediatrics

Chronic gastritis in pediatrics

Helicobacter pylori-Associated Iron Deficiency Anemia in Childhood and Adolescence-Pathogenesis and Clinical Management Strategy

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