Helicobacter pylori and iron deficiency anaemia in children

Background: Both iron deficiency anaemia and Helicobacter pylori infection are rare in developed countries. A possible connection has been suggested b etween these two diseases and our aim was to define the clinical picture an d to study the effect of bacterial eradication in H. pylori colonized child ren with severe anaemia. Methods: Eight children with iron deficiency anaem ia refractory to iron supplementation were examined with gastroscopy becaus e of suspicion of H. pylori infection. Anaemia was treated with oral ferrou s sulphate. Two patients needed blood transfusions. Eradication therapy was given either with combination of colloidal bismuth subcitrate and metronid azole or with omsprazole, clarithromycin and amoxycillin. Eradication was c onfirmed by urea breath test 4 weeks post-treatment. Results: H. pylori inf ection was confirmed histologically and microbiologically in ail children, who also presented with chronic, active gastritis. Bacteria were successful ly eradicated in 7/8 patients. Correction of haemoglobin values was observe d post-treatment, iron stores still being deficient at control in 4/8 child ren. Conclusions: Our results suggest that H. pylori might have a role in c ausing iron deficiency anaemia in school-age children. Screening for H. pyl ori should be extended to cover those patients with other clinical manifest ations than symptoms from gastrointestinal tract.