Background: Adult patients with insulin-dependent diabetes mellitus frequently also show gastric disturbances. Knowledge of the prevalence of such abnormalities in children with insulin-dependent diabetes and the predictive value of anti-gastric parietal cell antibodies in blood may be of practical importance.
Patients and methods: 68 patients (29 boys and 39 girls), aged from 5 yr 2 mo to 19 yr 10 mo, and treated for insulin-dependent diabetes from 1 mo to 14 yr 6 mo, were included in the study. Fasting blood concentrations of gastrin (G), pepsinogen (PG1), anti-gastric parietal cell antibodies (PCA) were measured. Fiberoptic endoscopy and biopsy of the gastroduodenal mucosa were performed in PCA+ patients and biopsy samples were examined for Helicobacter pylori (HP).
Results: 12 patients were PCA+; 3 of them had blood gastrin levels above 104 pg/ml and 4 had blood pepsinogen levels 24 ng/ml. Histologically, 3 patients had chronic diffuse gastritis (2 were HP+); 2 had chronic gastritis restricted to the antro-pyloric area (both were HP+); 3 had follicular lymphoid hyperplasia (without HP) and 4 had normal mucosa (without HP).
Conclusion: The presence of PCA can predict the risk of chronic gastritis, possibly auto-immune in origin, in children with insulin-dependent diabetes.