Helicobacter pylori infection in children with celiac disease: Prevalence and clinicopathologic features

Background: Celiac disease is frequently associated with chronic gastritis, Helicobacter pylori is the main etiologic agent of chronic gastritis. The aim of this study was to assess the prevalence of H. pylori, the related sy mptoms, and the endoscopic and histologic gastric features in children with celiac disease. Methods: Eight-one (24 boys, 57 girls; age range: 1.4-17.7 years, median 6. 8) children with celiac disease were studied. All children had a blood samp le taken. In a subgroup of 30 children who underwent endoscopy, three gastr ic biopsy specimens were taken for histology (hematoxylin and eosin, Giemsa , immunohistochemistry) and urease quick test. Symptom complaints were reco rded. Age- and sex-matched (one case, one control) children without celiac disease were used for comparison. son. Serum H. pylori IgG were measured by means of a locally validated commercial enzyme-linked immunoassay. Results: Overall, 15 of 81 (18.5%) children with celiac disease and 14 of 8 1 (17.3%) control children were positive for H. pylori. The percentage of H . pylori positivity was similar in children with untreated and treated celi ac disease. Recurrent abdominal pain was the only symptom that helped to di stinguish between H. pylori-positive and H. pylori-negative children. Howev er, symptoms disappeared in patients with celiac disease after gluten withd rawal, irrespective of H. pylori status. All endoscopic (erythema, nodulari ty) and histologic (superficial-, interstitial-, lymphocytic-gastritis, act ivity, lymphoid follicles) findings did not differ between celiac and nonce liac H. pylori-positive children. Conclusions: Prevalence and clinical expressivity of H. pylori infection is not increased in children with celiac disease. The clinicopathologic patte rn of the infection is not specifically influenced in this condition.