Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection

J Pediatr Gastroenterol Nutr. 2004 Feb;38(2):146-51. doi: 10.1097/00005176-200402000-00008.

Abstract

Objectives: Helicobacter pylori has been established as a major cause of gastritis and peptic ulcer disease in adults and children. H. pylori infection may also have a role in the development of some extra-gastrointestinal diseases, including iron deficiency anemia. The aim of this study is to investigate H. pylori-related changes in gastric physiology and histology and the relationship of these changes to iron deficiency anemia in children.

Methods: Fifty-two patients with gastrointestinal complaints were studied. Hematologic parameters, 3-day vitamin C and iron consumption, serum gastrin levels, and gastric juice ascorbic acid levels were compared in patients with and without H. pylori infection. Dietary intake of vitamin C and iron, serum gastrin, gastric juice ascorbic acid content, and gastric histology were compared in patients with H. pylori infection and anemia and in patients with H pylori infection and no anemia. The CagA status of the H. pylori organisms was evaluated.

Results: Twenty-eight of 52 patients had H. pylori. Thirty-one patients had iron deficiency anemia. H. pylori infection was associated with low serum iron levels. H. pylori gastritis was associated with a decrease in the gastric juice ascorbic acid level. Infection with CagA-positive strains was associated with a greater decrease in gastric juice ascorbic acid than infection with CagA-negative strains. However, the gastric juice ascorbic acid levels of patients with H. pylori and anemia were not different from those of non-anemic patients with H. pylori. Among patients with H. pylori infection, pangastritis was twice as common in those with anemia than in those without anemia.

Conclusions: H. pylori infection was associated with a decrease in gastric juice ascorbic acid concentration, and this effect was more pronounced in patients with the CagA-positive strain. Pangastritis was more common in patients whose H. pylori.infection was accompanied by anemia.

MeSH terms

  • Anemia, Iron-Deficiency / etiology*
  • Anemia, Iron-Deficiency / microbiology
  • Antigens, Bacterial / analysis
  • Ascorbic Acid / metabolism
  • Bacterial Proteins / analysis
  • Child
  • Female
  • Gastric Acid / metabolism*
  • Gastric Acidity Determination
  • Gastrins / blood
  • Gastritis / epidemiology
  • Gastritis / microbiology
  • Helicobacter Infections / complications*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / chemistry*
  • Helicobacter pylori / pathogenicity
  • Humans
  • Intestinal Absorption / physiology
  • Iron / blood
  • Iron / metabolism*
  • Iron, Dietary / pharmacokinetics*
  • Male
  • Stomach / pathology
  • Virulence

Substances

  • Antigens, Bacterial
  • Bacterial Proteins
  • Gastrins
  • Iron, Dietary
  • cagA protein, Helicobacter pylori
  • Iron
  • Ascorbic Acid