The etiology of chronic gastritis in children with celiac disease

Autor: E.A. Dementyeva, K. A. Klikunova, A.I. Khavkin, N.S. Shapovalova, M.O. Revnova, V.P. Novikova
Rok vydání: 2020
Předmět:
Zdroj: Voprosy detskoj dietologii. 18:5-12
ISSN: 2414-9519
1727-5784
Popis: Study objective. To investigate the etiology of chronic gastritis in children with various forms of coeliac disease. Patients and methods. 176 children with various forms of coeliac disease and morphologically verified chronic gastritis (CG) were examined. The first group consisted of 58 children with CG and newly diagnosed CD who did not adhere to a gluten-free diet (GFD), the second group included 49 children with CG and CD on a GFD. The comparison group (group 3) consisted of 69 children with CG but without CD. Morphological examination of the gastric and duodenal mucous membrane was performed. Verification of Helicobacter pylori infection for all participants was carried out by the rapid urease test (RUT) and the histological detection of the rod forms of H. pylori in any part of the gastric mucosa. Serological examination included determination of tissue transglutaminase IgA и IgG antibodies and deamidated gliadin peptide IgG antibodies; anti-parietal cell antibodies, IgG. Results. H. pylori was equally often detected in children with CD and in the control group: in group 1 – 63.8%, in group 2 – 53.1%, in group 3 – 68.1% (p1-2 = 0.387; p1-3 = 0.954; p2-3 = 0.420). Anti-parietal cell antibodies were equally common in groups 1 and 3, but were not detected in group 2: in group 1 – 14.9%, in group 3 – 10.1% (p1-2 = 0.002; p1-3 = 0.562; p2-3 = 0.012). Most often, the etiology of CG remained undetermined in group 2, among children with CD, who adhere to the GFD: group 1 – 19%, group 2 – 40.8%, group 3 – 15.9% (p1-2 = 0.025; p1-3 = 0.776; p2-3 = 0.012). CG associated with bile reflux was found in all groups without statistically significant differences: in group 1 – 5.2%, in group 2 – 6.1%, in group 3 – 5.8% (p1-2 = 0.877; p1-3 = 0.916; p2-3 = 0.960). The level of antibodies to Castle’s factor correlated with the level of antibodies to tissue transglutaminase r = 0.483; p = 0.002. Conclusion. The study data are suggestive of a systemic effect of celiac disease on the gastric mucosa. The stomach, along with the small intestine, is a target organ for celiac disease. The coexistence of primary immune-mediated lesion of the gastric mucosa and the H. pylori-induced inflammatory and autoimmune proсess is also possible. The prevalence of H. pylori in CD does not depend on a gluten-free diet and does not differ from the prevalence of H. pylori in CG. Key words: celiac disease, chronic gastritis, children
Databáze: OpenAIRE
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