Unique Features of Helicobacter Pylori Disease in Children

Hassall, Eric; Dimmick, James E.

doi:10.1097/00006454-199204000-00025

Cited by 58 publications

(95 citation statements)

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“…Em nosso estudo, a hemorragia foi a manifestação clínica mais freqüente de complicação da úlcera, enquanto que na literatura a freqüência de hemorragia digestiva alta como sintoma de apresentação varia de 24 a 80% dos pacientes 1,20 . Hematêmese isolada sem dor abdominal ocorreu em 15,8% (3/19) dos pacientes, mas pode ocorrer em até 25% dos casos 21 . Houve apenas um paciente com obstrução pilórica, enquanto que estudo realizado no sul da Índia em 1983 22 refere 8/12 pacientes com estenose pilórica em 29 pacientes com úlcera duodenal em 18 anos; outros autores referem taxas bem menores.…”

Section: Discussionunclassified

“…Em pacientes adultos, tem-se evidenciado predomínio de infiltrado polimorfonuclear 25 , enquanto que, em crianças, o infiltrado inflamatório é geralmente mais crônico, com um número significativamente maior de células linfoplasmocitárias em relação ao de células polimorfonucleares 21 . Porém, os achados histológicos em crianças infectadas não são uniformes, parecendo depender da condição socioeconômica 26 .…”

Section: Discussionunclassified

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Clinical and histological features of duodenal ulcer in children and adolescents

Kawakami¹,

Machado²,

Fonseca³

et al. 2004

J Pediatr (Rio J)

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Objective: To evaluate clinical and histological features of duodenal ulcer in children and adolescents.Methods: Forty-three children with duodenal ulcer were prospectively and consecutively evaluated in a 6 year period (7.2 patients per year). Evaluation included clinical questionnaire focused on dyspeptic symptoms, physical examination, and digestive endoscopy with gastric biopsies for histological examination and Helicobacter pylori detection.Results: Diagnostic age ranged from 4 years and 8 months to 17 years and 4 months (mean age: 12 years and 4 months). Abdominal pain was the main symptom (39/43, 90.7%), which was epigastric in 31/39, periumbilical in 7/39, and nocturnal in 27/39. Other symptoms were loss of appetite (32/43, 74 ResumoObjetivo: Avaliar as características clínicas e histológicas de crianças e adolescentes com úlcera duodenal.Métodos: Foram avaliadas prospectiva e consecutivamente 43 pacientes com úlcera duodenal ao longo de 6 anos (7,2 pacientes por ano). A avaliação consistiu de questionário clínico de sintomas dispép-ticos, exame físico e endoscopia digestiva com biópsias gástricas para exame histológico e detecção do Helicobacter pylori.Resultados: A idade no diagnóstico variou de 4 anos e 8 meses a 17 anos e 4 meses (mediana = 12 anos e 4 meses ARTIGO ORIGINALGastrite crônica associada à infecção por Helicobacter pylori está presente na grande maioria das crianças com úlcera duodenal primária, havendo consenso para o tratamento de erradicação da bactéria, pela diminuição acentuada do índice de recidivas ulcerosas 1 . A colonização da mucosa gástrica por H. pylori, bacilo gram-negativo, microaerofílico, espiralado, atualmente ocorre em uma minoria das crianças de países desenvolvidos, ao contrário das crianças de países em desenvolvimento, sendo a prevalên-cia até 10 anos de idade de 5-10% e até 80%, respectivamente 2 . Os principais fatores de risco para contrair a infecção são: viver em país em desenvolvimento e ser criança com pais infectados e de baixo poder aquisitivo 3 . A maioria dos pacientes é assintomática, estimando-se que cerca de 15% evoluem para úlcera péptica e 1% para câncer gástrico 4 . Após a instalação da gastrite, a bactéria geralmente persiste por toda a vida, sendo rara a erradicação espontânea. Não há conclusão definitiva a respeito da influência dos fatores de virulência da bactéria, assim como da resposta do hospedeiro ou das condições ambientais que poderiam interferir no curso evolutivo desta afecção.

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Section: Discussionunclassified

Clinical and histological features of duodenal ulcer in children and adolescents

Kawakami¹,

Machado²,

Fonseca³

et al. 2004

J Pediatr (Rio J)

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“…4,15 It is our experience that when H. pylori gastritis is associated with duodenal ulcer in children, a striking di use nodularity of the antrum always is present; when H. pylori causes gastritis alone, this nodularity is seen in only about 50±60% of cases. 4 We have not seen this nodularity in cases of true non-H. pylori duodenal ulcer disease, nor in any of the some 5000 upper gastrointestinal endoscopies at which neither ulcer disease nor H. pylori were present over the last 14 years; in our experience, about 20% of duodenal ulcer disease in children is non-H. pylori-associated. 13 Nodularity is sometimes not visible on ®rst examination of the antrum, but once biopsies have been taken, oozing blood acts as a vital stain, making visible a con¯uent carpet of nodules ( Figure 1); the term recently coined for this is`haematochromoendoscopy'.…”

Section: Helicobacter Pylori-associated Ulcer Diseasementioning

confidence: 98%

“…12 In our own patients, antral gastritis scores were higher in those with H. pylori-associated duodenal ulcer than in those without ulcers, and virtually absent in those with H. pylori-negative ulcer disease. 4,13 Although normal gastric histology has been reported in children infected with H. pylori 14 ,`normal' and`gastritis' were not quantitatively de®ned, and few biopsies were taken per patient for histology.…”

Section: Helicobacter Pylori-associated Ulcer Diseasementioning

confidence: 99%

“…The absence of endoscopic abnormalities in some 50% of children with H. pylori infection 4 , and the patchy nature of the infection and of gastric mucosa-associated lymphoid tumour (MALT) lymphomas, emphasizes the need to take biopsies from the gastric antrum, body and cardia as an integral part of diagnostic endoscopy. 12,18±20 Consensus guidelines for an approach to the diagnosis and treatment of H. pylori are given in detail elsewhere 21 and summarized below.…”

Section: Helicobacter Pylori-associated Ulcer Diseasementioning

confidence: 99%

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Peptic ulcer disease in children

Dohil

Hassall

2000

Best Practice & Research Clinical Gastroenterology

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What Is New Related to Helicobacter pylori Infection in Children and Teenagers?

Kato

Sherman²

2005

Arch Pediatr Adolesc Med

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Helicobacter pylori infection is a common bacterial infection for humans, and the organism is the most prevalent gastric microbial pathogen. However, the major route of transmission remains poorly understood. The outcome of chronic H pylori infection varies from asymptomatic gastritis to peptic ulceration and gastric malignancies. Recently, H pylori has been associated with the development of extradigestive disorders, including refractory iron-deficiency (sideropenic) anemia and chronic autoimmune thrombocytopenic purpura. Virulence factors of H pylori and host genetic factors are both considered important determinants of disease outcome. Multiple tests, including novel noninvasive approaches, are available for establishing the presence of H pylori infection, but there is still little consensus about which study should be performed and in what clinical setting. Eradicating H pylori uses combination therapy, including a proton pump inhibitor and 2 antibiotics taken twice daily for 7 to 14 days. Antibiotic resistance is a growing and serious problem that interferes with the success of eradication therapy. Testing and eradication therapy for H pylori are currently recommended only for the subset of infected persons in whom the disease sequelae are proven or highly suspected.

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Unique Features of Helicobacter Pylori Disease in Children

Cited by 58 publications

References 0 publications

Clinical and histological features of duodenal ulcer in children and adolescents

Clinical and histological features of duodenal ulcer in children and adolescents

Peptic ulcer disease in children

What Is New Related to Helicobacter pylori Infection in Children and Teenagers?

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