Randomized placebo-controlled trial of Helicobacter pylori eradication foriron-deficiency anemia in preadolescent children and adolescents

Background. A few cases relating H. pylori infection to iron-deficiency ane mia have been described recently. We investigated the role of H. pylori inf ection in iron-deficiency anemia in preadolescent children and adolescents. Patients and Methods. We conducted a double-blind, placebo-controlled thera peutic trial in 43 subjects (mean age, 15.4 years) with iron-deficiency ane mia. Endoscopy was performed, and biopsy specimens were examined by urease test and histological analysis. Twenty-two of 25 H. pylori-positive patient s were assigned randomly to three groups. Group A patients were given oral ferrous sulfate and a 2-week course of bismuth subcitrate, amoxicillin, and metronidazole. Group B patients were given placebo for iron and a 2-week c ourse of triple therapy. Group C patients were given oral ferrous sulfate a nd a 2-week course of placebo. Iron status was reassessed 4 weeks and 8 wee ks after the 2-week regimen ended. Results. Of the 43 subjects with iron-deficiency anemia, 25 (58.1%) had H. pylori in the antrum. Group A and B subjects, who received eradication ther apy, showed a significant increase in hemoglobin level as compared with gro up C subjects at 8 weeks after therapy (p =.0086). Conclusions. Treatment of H. pylori infection was associated with more rapi d response to oral iron therapy as compared with the use of iron therapy al one. Such treatment also led to enhanced iron absorption even in those subj ects who did not receive oral iron therapy.