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A Localized Case–Control Study of Extra-Gastric Manifestations of Helicobacter pylori Infection in Children

  • Original Article
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The Indian Journal of Pediatrics Aims and scope Submit manuscript

An Erratum to this article was published on 09 September 2011

Abstract

Objective

To study extra- gastric manifestations of H. pylori infection among children in Egypt.

Methods

This case–control study in which sixty H pylori positive children were compared to sixty H pylori negative children was conducted. Full history taking, clinical examination, CBC, serum iron, serum ferritin in addition to H pylori antibody testing were performed.

Results

Mean hemoglobin, MCV, MCH, serum iron and serum ferritin were all less in seropositive patients but these were statistically non significant. Iron deficiency (ID) was defined as serum ferritin less than 12 ng/ml; and Iron deficiency anemia (IDA) as hemoglobin less than 11 g/dL in addition to ID. Seropositive patients showed increased frequency of ID and IDA and this was statistically significant (0.003 & 0.000 respectively). There was no statistically significant difference as regards the platelet counts of the two groups or the presence of skin disorders or the gender.

Conclusions

There is increased incidence of ID and IDA among H pylori positive children. This needs to be confirmed by larger therapeutic randomized controlled trials. The hematological response to eradication therapy needs to be further studied.

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Abbreviations

Anti-Hp:

Anti-helicobacter pylori

CBC:

Complete blood count

EDTA:

Ethylene diamine tetra acetic acid

F:

Female

Hb:

Hemoglobin

Helicobacter pylori :

H pylori

ID:

Iron deficiency

IDA:

Iron deficiency anemia

ITP:

Idiopathic thrombocytopenic purpura

M:

Male

MCH:

Mean cell hemoglobin

MCV:

Mean cell volume

PLT:

Platelet count

S: Iron:

Serum iron

SD:

Standard deviation

SPSS:

Statistical Package for the Social Science

References

  1. Ashorn M, Rago T, Kokkonen J, Ruuska T, Rautelin H, Karikoski R. Symptomatic response to Helicobacter pylori eradication in children with recurrent abdominal pain: double blind randomized placebo control trial. J Clin Gastroenterol. 2004;38:646–50.

    Article  PubMed  Google Scholar 

  2. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med. 2002;347:1175–86.

    Article  PubMed  CAS  Google Scholar 

  3. Kato S, Sherman PM. What is new related to Helicobacter pylori infection in children and teenagers? Arch Pediatr Adolesc Med. 2005;159:415–21.

    Article  PubMed  Google Scholar 

  4. Linneberg A, Ostergaard C, Tvede M, et al. IgG antibodies against microorganisms and atopic disease in Danish adults: the Copenhagen allergy study. J Allergy Clin Immunol. 2003;111:847–53.

    Article  PubMed  CAS  Google Scholar 

  5. Uter W, Stock C, Pfahlberg A, et al. Association between infections and signs and symptoms of atopic hypersensitivity: results of a cross-sectional survey among first-year university students in Germany and Spain. Allergy. 2003;58:580–4.

    Article  PubMed  CAS  Google Scholar 

  6. Federman DG, Kirsner RS, Moriarty JP, Concato J. The effect of antibiotic therapy for patients infected with Helicobacter pylori who have chronic urticaria. J Am Acad Dermatol. 2003;49:861–4.

    Article  PubMed  Google Scholar 

  7. Poddar U, Yachha SK. Helicobacter pylori in children: an Indian perspective. Indian Pediatr. 2007;44:761–70.

    PubMed  Google Scholar 

  8. Gill HH, Majumdar P, Shankaran K, Desai HG. Age related prevalence of Helicobacter pylori antibodies in Indian subjects. Indian J Gastroenterol. 1994;13:92–9.

    PubMed  CAS  Google Scholar 

  9. Graham DY, Adam E, Reddy GT, et al. Seroepidemiology of Helicobacter pylori infection in India: comparison of developing and developed countries. Dig Dis Sci. 1991;36:1084–8.

    Article  PubMed  CAS  Google Scholar 

  10. Dore SP, Krupadas S, Borgonha S, Kurpad AV. The 13C urea breath test to assess Helicobacter pylori infection in school children. Natl Med J India. 1997;10:57–60.

    PubMed  CAS  Google Scholar 

  11. Crompton DW, Nesheim MC. Nutritional impact of intestinal helminthiasis during the human life cycle. Annu Rev Nutr. 2002;22:35–59.

    Article  PubMed  CAS  Google Scholar 

  12. Fernández-Bañares F, Monzón H, Forné M. A short review of malabsorption and anemia. World J Gastroenterol. 2009;15:4644–52.

    Article  PubMed  Google Scholar 

  13. Fayed SB, Aref MI, Fathy HM, et al. Prevalence of celiac disease, Helicobacter pylori and gastroesophageal reflux in patients with refractory iron deficiency anemia. J Trop Pediatr. 2008;54:43–53.

    Article  PubMed  Google Scholar 

  14. Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol. 2006;163:127–34.

    Article  PubMed  Google Scholar 

  15. Bode G, Rothenbacher D, Brenner H, Adler G. Helicobacter pylori and abdominal symptoms: a population based study among preschool children in southern Germany. Pediatrics. 1998;101:634–7.

    Article  PubMed  CAS  Google Scholar 

  16. Oderda G, Dell’Ollio D, Morra I, Ansaldi N. Campylobacter pylori gastritis: long term results of treatment with amoxycillin. Arch Dis Child. 1989;64:326–9.

    Article  PubMed  CAS  Google Scholar 

  17. Macarthur C, Saunders N, Feldman W. Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain. JAMA. 1995;273:729–34.

    Article  PubMed  CAS  Google Scholar 

  18. Singh M, Prasad KN, Yachha SK, Saxena A, Krishnani N. Helicobacter pylori infection in children: prevalence, diagnosis and treatment outcome. Trans R Soc Trop Med Hyg. 2006;100:227–33.

    Article  PubMed  Google Scholar 

  19. Tindberg Y, Nyren O, Blennow M, Granstrom M. Helicobacter pylori infection and abdominal symptoms among Swedish school children. J Pediatr Gastroenterol Nutr. 2005;41:33–8.

    Article  PubMed  Google Scholar 

  20. Spee LA, Madderom MB, Pijpers M, van Leeuwen Y, Berger MY. Association between Helicobacter pylori and gastrointestinal symptoms in children. Pediatrics. 2010;125:e651–69.

    Article  PubMed  Google Scholar 

  21. Baggett HC, Parkinson AJ, Muth PT, Gold BD, Gessner BD. Endemic iron deficiency associated with Helicobacter pylori infection among school-aged children in Alaska. Pediatrics. 2006;117:e396–404.

    Article  PubMed  Google Scholar 

  22. Muhsen K, Cohen D. Helicobacter pylori infection and iron stores: a systematic review and meta-analysis. Helicobacter. 2008;13:323–40.

    Article  PubMed  CAS  Google Scholar 

  23. Muhsen K, Barak M, Shifnaidel L, Nir A, Bassal R, Cohen D. Helicobacter pylori infection is associated with low serum ferritin levels in Israeli Arab children: a seroepidemiologic study. J Pediatr Gastroenterol Nutr. 2009;49:262–4.

    Article  PubMed  CAS  Google Scholar 

  24. Choe YH, Kim SK, Hong YC. Helicobacter pylori infection with iron deficiency anaemia and subnormal growth at puberty. Arch Dis Child. 2000;82:136–40.

    Article  PubMed  CAS  Google Scholar 

  25. Choe YH, Kim SK, Hong YC. The relationship between Helicobacter pylori infection and iron deficiency: seroprevalence study in 937 pubescent children. Arch Dis Child. 2003;88:178.

    Article  PubMed  CAS  Google Scholar 

  26. Milman N, Rosenstock SJ, Andersen LP, Jørgensen T, Bonnevie O. The relationship of Helicobacter pylori to iron status—serum ferritin and hemoglobin. A seroepidemiologic survey of 2794 Danes. Ugesker Laeger. 2000;162:1564–7.

    CAS  Google Scholar 

  27. Konno M, Muraoka S, Takahashi M, Imai T. Iron-deficiency anemia associated with Helicobacter pylori gastritis. J Pediatr Gastroenterol Nutr. 2000;31:52–6.

    Article  PubMed  CAS  Google Scholar 

  28. Ashorn M, Ruuska T, Mäkipernaa A. Helicobacter pylori and iron deficiency anaemia in children. Scand J Gastroenterol. 2001;36:701–5.

    Article  PubMed  CAS  Google Scholar 

  29. Kurekci AE, Atay AA, Sarici SU, et al. Is there a relationship between childhood Helicobacter pylori infection and iron deficiency anemia? J Trop Pediatr. 2005;51:166–9.

    Article  PubMed  CAS  Google Scholar 

  30. Valiyaveettil AN, Hamide A, Bobby Z, Krishnan. Effect of anti-Helicobacter pylori therapy on outcome of iron-deficiency anemia: a randomized, controlled study. Indian J Gastroenterol. 2005;24:155–7.

    PubMed  Google Scholar 

  31. Gessner BD, Baggett HC, Muth PT, et al. A controlled, household-randomized, open-label trial of the effect that treatment of Helicobacter pylori infection has on iron deficiency in children in rural Alaska. J Infect Dis. 2006;193:537–46.

    Article  PubMed  Google Scholar 

  32. Sarker SA, Mahmud H, Davidsson L, et al. Causal relationship of Helicobacter pylori with iron-deficiency anemia or failure of iron supplementation in children. Gastroenterology. 2008;135:1534–42.

    Article  PubMed  CAS  Google Scholar 

  33. Franchini M, Cruciani M, Mengoli C, Pizzolo G, Veneri D. Effect of Helicobacter pylori eradication on platelet count in idiopathic thrombocytopenic purpura: a systematic review and meta-analysis. J Antimicrob Chemother. 2007;60:237–46.

    Article  PubMed  CAS  Google Scholar 

  34. Arnold DM, Stasi R. Does Helicobacter pylori eradication therapy result in a platelet count improvement in adults with immune thrombocytopenic purpura regardless of H pylori infection? ASH evidence-based review. Hematology Am Soc Hematol Educ Program. 2008;2008:31–2.

    Article  Google Scholar 

  35. Neefjes VM, Heijboer H, Tamminga RY. H. pylori infection in childhood chronic immune thrombocytopenic purpura. Haematologica. 2007;92:576.

    Article  PubMed  Google Scholar 

  36. Wedi B, Raap U, Wieczorek D, Kapp A. Urticaria and infections. Allergy Asthma Clin Immunol. 2009;5:10.

    Article  PubMed  Google Scholar 

  37. Galadari IH, Sheriff MO. The role of Helicobacter pylori in urticaria and atopic dermatitis. Skinmed. 2006;5:172–6.

    Article  PubMed  Google Scholar 

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Acknowledgements

We are thankful to Prof. Magdy Ibrahim for the statistical assistance he provided for this work. Prof. Magdy Ibrahim is Prof. Obstetrics and Gynecology, Faculty of Medicine, Cairo University and is Director Research and Biostatistics Unit, MEDC, Cairo University.

Contributions

ARA; The idea and design of the study, enrollment of patients, collection of data, writing the manuscript, ADK; enrollment of patients, collection of data, SIA; All the lab work.

Conflict of Interest

None.

Role of Funding Source

None.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt

    Rasha Abdel-Raouf Afifi & Dina Kamal Ali

  2. Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt

    Iman Abdel-Mohsen Shaheen

Authors
  1. Rasha Abdel-Raouf Afifi
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  2. Dina Kamal Ali
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  3. Iman Abdel-Mohsen Shaheen
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Corresponding author

Correspondence to Rasha Abdel-Raouf Afifi.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s12098-011-0558-y

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Afifi, R.AR., Ali, D.K. & Shaheen, I.AM. A Localized Case–Control Study of Extra-Gastric Manifestations of Helicobacter pylori Infection in Children. Indian J Pediatr 78, 418–422 (2011). https://doi.org/10.1007/s12098-010-0308-6

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  • DOI: https://doi.org/10.1007/s12098-010-0308-6

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