Clinical presentation and outcomes of Helicobacter heilmanniigastritis in children in the New England region of the United States

Autor: Chang, Denis, Gluchowski, Nina L., Abu Alfa, Amer K., Goldsmith, Jeffrey D., Redston, Mark, Bonilla, Silvana
Zdroj: Journal of Pediatric Gastroenterology & Nutrition; February 2024, Vol. 78 Issue: 2 p204-210, 7p
Abstrakt: To describe the clinical, endoscopic, histologic, and treatment outcomes of Helicobacter heilmannii(H. heilmannii) associated gastritis in children in the New England region of the United States. Retrospective study of children (1–18 years) with H. heilmanniiidentified on gastric mucosal biopsies from two pediatric centers over a 21‐year period, January 2000–December 2021. Cases were identified by querying pathology databases at each institution. Demographic and clinical data were obtained from the medical record. Endoscopic and histologic findings were extracted from endoscopy and pathology reports, respectively. Thirty‐eight children were diagnosed with H. heilmannii‐associated gastritis during the study period. The mean age at diagnosis was 10.1 ± 5.3 years, and 25/38 (66%) cases were male. Abdominal pain (32%) and nausea with or without vomiting (26%) were the most common symptoms. Thirty‐two children (84%) had endoscopic findings including gastric nodularity (55%) and erythema (26%). All children had histologic signs of chronic gastritis, including those with normal endoscopic exams. Antibiotic regimens used for treating Helicobacter pyloriwere frequently prescribed. Of the 17 children who underwent a follow‐up endoscopy (range 2–68 months), 15 (88%) did not have H. heilmanniiidentified on gastric biopsies. H. heilmanniiwas an infrequent but potential cause of epigastric abdominal pain and nausea in our cohort of New England children. While morphologically distinct from H. pylori, the bacteria can result in similar endoscopic and histologic findings of nodularity and chronic gastritis, respectively. The rate of eradication, as assessed by histology following treatment with H. pyloritherapies, was below the 90% recommended goal for antimicrobial therapies. Helicobacter heilmannii (H. heilmannii)are gram‐negative bacteria that colonize the stomach in both humans and animals.Diagnosis is made when the spiral‐shaped bacteria are seen in gastric mucosal biopsies obtained during endoscopy. Helicobacter heilmannii (H. heilmannii)are gram‐negative bacteria that colonize the stomach in both humans and animals. Diagnosis is made when the spiral‐shaped bacteria are seen in gastric mucosal biopsies obtained during endoscopy. Abdominal pain and nausea are the most common symptoms of H. heilmannii‐associated gastritis in our pediatric cohort.Endoscopic and histologic sequelae of the bacteria are similar to those seen with Helicobacter pylori (H. pylori)infection, although the severity of inflammation was milder.Antibiotic regimens used for treating H. pylori, are often prescribed, but fall short of the recommended 90% target rate for eradication. Abdominal pain and nausea are the most common symptoms of H. heilmannii‐associated gastritis in our pediatric cohort. Endoscopic and histologic sequelae of the bacteria are similar to those seen with Helicobacter pylori (H. pylori)infection, although the severity of inflammation was milder. Antibiotic regimens used for treating H. pylori, are often prescribed, but fall short of the recommended 90% target rate for eradication.
Databáze: Supplemental Index