Characteristics and prevalence of Helicobacter heilmannii infection in children undergoing upper gastrointestinal endoscopy

Background: Helicobacter heilmannii, described in 1983 as a new cause of ch ronic gastritis, has been reported rarely in children. The purpose of this study was to determine the clinical characteristics and the prevalence of I i. heilmannii infection, in comparison with Helicobacter pylori infection i n children undergoing upper digestive endoscopy. Methods: Diagnosis of H, heilmannii was based on its morphologic characteri stics in gastric biopsy specimens (two from the antrum, one from the fundus ), whereas H. pylori infection was defined by histology and/or culture (one specimen from the antrum, one from the fundus). Respective prevalences of H. heilmannii and H. pylori were calculated in 518 patients studied prospec tively who underwent systematic biopsies. Results: The prevalence of Ii. pylori was 8.9% (46/518) and increased with age (from 2% before 3 years of age to 18% after 10 years). On the contrary, the prevalence of H. heilmannii infection was low, 0.4% (2/518), and no di fferent from that published in adults. After completion of the study period , a third H. heilmannii-infected child was diagnosed. Characteristics of Ii . heilmannii infection could be studied in these three children 5, 9, and 1 3 years old. Two of three had abdominal pain and one had dysphagia. Nodular gastritis was observed at endoscopy in two children. H. heilmannii chronic active gas tritis (n = 3) was localized in the antrum, associated with an interstitial infiltrate, and could not be distinguished from H. pylori gast ritis (n = 46). Conclusion: Clinical characteristics, endoscopic features and gastric histo pathology did not allow H. heilmannii to be distinguished from H. pylori ga stritis in our pediatric population. H. heilmannii infection should be cons idered and carefully looked for juring histologic examination of gastric sp ecimens in cases of H. pylori-negative gastritis.