Evaluation of gastric histology in children and adolescents with Helicobacter pylori gastritis using the Update Sydney System

CONTEXT: Although Helicobacter pylori infection is prevalent in our country, there are few studies evaluating the associated histological abnormalities in children. OBJECTIVE: To evaluate the histological features of the gastric mucosa in children and adolescents with Helicobacter pylori gastritis....

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Detalles Bibliográficos
Autores: Langner, Marini [UNIFESP], Machado, Rodrigo S. [UNIFESP], Patricio, Francy Reis da Silva [UNIFESP], Kawakami, Elisabete [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2009
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/5379
Acceso en línea:http://dx.doi.org/10.1590/S0004-28032009000400015
http://repositorio.unifesp.br/handle/11600/5379
Access Level:acceso abierto
Palabra clave:Gastritis, classification
Helicobacter infections
Gastric mucosa
Adolescent
Child
Gastrite, classificação
Infecções por helicobacter
Mucosa gástrica
Adolescente
Criança
Descripción
Sumario:CONTEXT: Although Helicobacter pylori infection is prevalent in our country, there are few studies evaluating the associated histological abnormalities in children. OBJECTIVE: To evaluate the histological features of the gastric mucosa in children and adolescents with Helicobacter pylori gastritis. METHODS: One hundred and thirty two gastric biopsies from 22 symptomatic patients infected with H. pylori (14F/8M, median age 10 y 5 mo, age range 2 y 11 mo to 16 y 9 mo) were evaluated. Evaluated gastric regions included: antrum (lesser and greater curvature), corpus (lesser and greater curvature), incisura angularis and fundus. Histological examination was performed according to the Updated Sydney System, and regional scores for polymorphonuclear and mononuclear cell infiltrate as well as bacterial density were generated. RESULTS: Fifteen (68.2%) patients presented H. pylori-chronic active gastritis, six (27.3%) presented antrum-predominant H. pylori-chronic active gastritis, and one (4.5%) presented corpus-predominant H. pylori-chronic active gastritis. Polymorphonuclear cell infiltrate and mononuclear cell infiltrate were observed in 93.9% and 98.5% of the biopsy specimens, respectively. Higher histological scores for polymorphonuclear infiltrate, mononuclear infiltrate, and bacterial density were observed in the gastric antrum. Intestinal metaplasia and gastric atrophy were not identified in any patient. Lymphoid aggregates and lymphoid follicles were observed in the gastric antrum of three (13.6%) and seven (31.8%) patients, respectively, but they were not related to antral nodularity. CONCLUSIONS: Chronic active gastritis was observed in all patients with H. pylori infection. However, antral or corporeal predominance was not observed in most patients.