Non-Helicobacter pylori related duodenal ulcer disease in children

Background. In spite of the worldwide distribution of Helicobacter pylori i nfection, recent data have reported an increased rate of non-H, pylori, non -NSAIDs-duodenal ulcer disease in adults. The estimated rate of these ulcer s in children is unknown. We aimed to investigate the prevalence of non-H. pylori, non-NSAIDs-peptic ulcer disease in our pediatric patients who under go upper endoscopic procedures. Methods. A retrospective analysis of 622 upper endoscopic reports was perfo rmed. Reports that documented mucosal ulcerations were included in our stud y. The demographic, clinical, endoscopic, and histological data were retrie ved. The H, pylori-negative, duodenal/gastric ulcer-positive patients were compared with H. pylori-positive, duodenal/gastric ulcer-positive patients. Results. Out of the 622 upper endoscopy reports, a total of 11 (1.8%) child ren with mucosal ulceration were studied. Mucosal ulceration was distribute d in the following locations: stomach-3 (27%), and duodenal bulb-10 (91%) ( two children had ulcers in both the stomach and duodenal bulb). Helicobacte r pylori infection was only detected in three (27%) children with duodenal ulcer. Gastritis was more severe in patients with H. pylori infection/duode nal ulcer compared with H. pylori-negative/duodenal ulcer group. No statist ical difference in clinical symptoms or endoscopic appearance was observed between the H. pylori-negative and H. pylori-positive groups. Conclusion. 'Idiopathic'(H. pylori-negative,NSAIDs-negative) duodenal/gastr ic ulcers are present in symptomatic children. Clinical or endoscopic chara cteristics are insufficient markers to identify those 'idiopathic' ulcers. Investigating the 'risk factors' for those ulcers will be helpful in reduci ng the morbidity in these children.