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2013 ; 86
(2
): 138-43
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Atrophic gastritis: Helicobacter pylori versus duodenogastric reflux
#MMPMID26527935
Sl?vescu KC
; M?rgescu C
; Pīrvan A
; ?arban C
; Gheban D
; Miu N
Clujul Med
2013[]; 86
(2
): 138-43
PMID26527935
show ga
OBJECTIVES: The objective of this study was to asses the prevalence of atrophic
gastritis in children. We also wanted to compare the clinical manifestation,
endoscopic appearance and the degree of the gastric atrophy in children and to
identify the possible causes which determine gastric atrophy. METHODS: We
evaluated 247 children with chronic gastritis (153 female/94 male, mean age 12.32
years). Atrophy was defined as the loss of normal glandular components, including
replacement with fibrosis and/or intestinal metaplasia. RESULTS: The prevalence
of the atrophic gastritis was 16.6% (41 cases), mean age 11.59+/-1.75 years,
male-to-female ratio 16:25. The clinical manifestations were correlated with the
patient age (infants and toddlers were evaluated mostly for weight loss - 4
cases, and older children for abdominal pain - 22 cases). The endoscopic
appearance was described as either nodular (15 cases), or erythematous gastritis
(10 cases), or normal (10 cases). According to the Sydney System, the degree of
atrophy was found to be mild in 3 patients, moderate in 25, and severe in 13
patients; 14 cases were associated with duodenogastric reflux, 5 with
Helicobacter pylori and 2 with Helicobacter heilmannii infection, but in 17 cases
the etiology was unknown. CONCLUSIONS: Atrophic gastritis is present in
childhood, even at very young ages (infants, toddlers). The endoscopic appearance
is not characteristic for the presence of atrophy. The degree of the atrophy is
not correlated with the age of the children. Because of the relatively high
number of duodenogastric reflux associated with gastric atrophy, further studies
need to evaluate the potential causes and clinical course.