Çocuklarda Helicobacter pylori enfeksiyonunun endoskopik, serolojik ve histolojik bulguları

Endoscopic, serologic and histological features of Helicobacter pylori infection in children

Özet

Erişkinlerde olduğu gibi çocuklarda da peptik ülser hastalığı ve gastrit ile ilişkili olan Helicobacter pylori (Hp) enfeksiyonu, çocuklarda klinik, endoskopik ve histolojik özellikleri bakımından farklılıklar gösterir. Bölgemizde çocuklarda Hp enfeksiyonunun klinik ve laboratuvar özelliklerini araştırmak amacıyla üst gastrointestinal sistem endpskopisi yapılan 39 hastada, histolojik olarak basil yoğunluğu, aktif ve kronik iltihap derecesi ve lenfoid follikül varlığından oluşan değerlendirme yanında, hızlı üreaz testi, ve kanda anti-Hp IgG antikorları çalışıldı. Histolojik olarak Hp pozitif hastalarda (n=25) basil yoğunluğu, aktif ve kronik iltihap ve lenfoid follikül skorları Hp negatif (n =14) hastalardan yüksek bulundu (p

Abstract

Helicobacter pylori (Hp) may cause gastritis and peptic ulcer disease in children as in adults. In children, endoscopic clinical and histological features of Hp infection are different from those seen in adults. The purpose of this study was to investigate the clinical and laboratory features of Hp infection in children in our region. Thirty-nine children undergoing endoscopy were investigated for presence of Hp infection by means of histology and, rapid urease test, and for anti-Hp IgG serology. Histological findings were scored according to modified Sydney system. All of the inflammation parameters were higher in the Hp-positive group than in the Hp-negative group. In some Hp infected children (n=8), after treatment with an anti-Hp regimen, all inflammation parameters improved except for lymphoid follicle score. We concluded that ( i ) Hp infection is acquired in childhood in our region, (ii) antral nodularity may be a feature of Hp infection in some children, (iii) sensitivity and specificity of rapid urease test is high and serology is low in Hp infection and (iv) the main inflammatory component of Hp infection in children is chronic inflammatory cells.