Çocuk Hastalarda Kronik Gastrit; Helicobacter Pylori mi Çölyak mı?

Year 2024, Volume: 26 Issue: 1, 42 - 45, 24.04.2024

Semih Sandal

https://doi.org/10.24938/kutfd.1402738

Abstract

Amaç: Merkezimizde kronik gastrit tanısı alan hastalarda Çölyak hastalığı (ÇH) ve Helikoobakter pilori (Hp) enfeksiyonu sıklığının, Hp ve kronik gastritin ÇH serolojisinde yanlış pozitiflik üzerine etkisinin belirlenmesi amaçlandı.
Gereç ve Yöntemler: Ocak 2021 ile Aralık 2022 tarihleri arasında mide ve ince bağırsak biyopsisi yapılan ve kronik gastrit tanısı alan 194 hasta çalışmaya dahil edildi. Hastalar Hp pozitif ve Hp negatif olarak 2 gruba ayrıldı. Ayrıca serolojik olarak ÇH şüphesi olan ancak biyopsisi histopatolojik olarak ÇH ile uyumlu olmayan olgularda Hp sıklığı ve aralarındaki ilişki değerlendirildi.
Bulgular: İncelenen 194 mide biyopsisinin 76'sında (%39.1) Hp tespit edildi. 27 olgunun 15'inde (%55,5) Hp saptandı ve aynı zamanda ÇH tanısı kondu. 194 hastanın 39'unda (%20,1) ÇH serolojisi pozitif bulunurken, yalnızca 27'sinde (%13,9) ÇH ile uyumlu histopatolojik değişiklikler saptandı.
Sonuç: Kronik gastrit ile Hp arasındaki ilişki açık olmasına rağmen, Hp ile ÇH arasındaki ilişki belirsizliğini korumaktadır. Bu ilişkinin anlaşılması için daha geniş hasta gruplarında Hp virülansının ve ÇH patofizyolojisi üzerine etkisinin araştırıldığı çalışmalara ihtiyaç olduğu kanaatindeyiz.

Keywords

Celiac disease, Helicobacter pylori, serology, gastritis

CHRONIC GASTRITIS IN PEDIATRIC PATIENTS; HELICOBACTER PYLORI OR CELIAC DISEASE?

Abstract

Objective: We aimed to determine the frequency of Celiac disease (CD) and Helicobacter pylori (Hp) infection, and the effect of Hp and chronic gastritis on patients with false positive CD serology in our center.
Material and Methods: We included 194 patients who had both stomach and small intestine biopsies and were diagnosed with chronic gastritis, between January 2021 and December 2022 in the study. Patients were divided into two groups: Hp- positive and Hp-negative.
Additionally, we evaluated the frequency and association of Hp in cases who were serologically suspected with CD but whose biopsies were not compatible with celiac disease histopathologically.
Results: Helicobacter pylori infection was detected in 76 of 194 gastric biopsies examined (39.1%). Hp positivity was detected in only 15 of 27 patients (55.5%) diagnosed with CD and CD serology was positive in 39 of 194 patients (20.1%), but histopathological changes compatible with CD were detected in only 27 (13.9%).
Conclusion: Although the relationship between chronic gastritis and Hp is clear, the relationship between Hp and CD remains unclear. We believe that studies with larger patient groups investigating Hp virulence and its effect on CD pathophysiology are needed to reveal this relationship.

Keywords

Helicobacter Pylori, Celiac, Gastritis, Serology

References

• Singh P, Arora A, Strand TA, et al. Global Prevalence of celiac disease: Systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2018;16(6):823-836.
• Staat MA, Kruszon-Moran D, McQuillan GM, Kaslow RA. A population-based serologic survey of Helicobacter pylori infection in children and adolescents in the United States. J Infect Dis. 1996;174(5):1120-1123.
• Konturek P, Karczewska E, Dieterich W, Hahn E, Schuppan D. Increased prevalence of Helicobacter Pylori infection in patients with celiac disease. Am J Gastroenterol. 2000;95(12):3682-3683.
• Jozefczuk J, Bancerz B, Walkowiak M, et al. Prevalence of Helicobacter pylori infection in pediatric celiac disease. Eur Rev Med Pharmacol Sci. 2015;19(11):2031-2035.
• Ciacci C, Squillante A, Rendina D, et al. Helicobacter pylori infection and peptic disease in coeliac disease. Eur J Gastroenterol Hepatol. 2000;12(12):1283-1287.
• Rubio-Tapia A, Hill ID, Kelly CP, Calderwood AH, Murray JA. ACG clinical guidelines: Diagnosis and management of celiac disease. Am J Gastroenterol. 2013;108(5):656-676.
• Gabrieli D, Ciccone F, Capannolo A, et al. Subtypes of chronic gastritis in patients with celiac disease before and after gluten-free diet. United European Gastroenterol J. 2017;5(6):805-810.
• Hayat M, Arora D, Dixon M, Clark B, O’Mahony S. Effects of Helicobacter pylori eradication on the natural history of lymphocytic gastritis. Gut. 1999;45(4):495-498.
• Levine A, Domanov S, Sukhotnik I, Zangen T, Shaoul R. Celiac-associated peptic disease at upper endoscopy: How common is it? Scand J Gastroenterol. 2009;44(12):1424- 1428.
• Aaron L, Torsten M, Patricia W. Autoimmunity in celiac disease: Extra-intestinal manifestations. Autoimmun Rev. 2019 Mar;18(3):241-246.
• Oderda G, Forni M, Morra I, Tavassoli K, Pellegrino P, Ansaldi N. Endoscopic and histologic findings in the upper gastrointestinal tract of children with coeliac disease. J Pediatr Gastroenterol Nutr. 1993;16(2):172-177.
• Banaszkiewicz A, Banasiuk M, Szaflarska-Popławska A, Mantei A, Albrecht P. Letter: Gastritis in pediatric patients with coeliac disease. Aliment Pharmacol Ther. 2016;44(9):1003-1004.
• Therrien A, Bernard G, Hetu PO, Bouin M. Letter: The coeliac stomach - a significant increase in tissue transglutaminase antibodies is associated with gastritis. Aliment Pharmacol Ther. 2017;45(9):1285-1286.
• Ciacci C, Squillante A, Rendina D, et al. Helicobacter pylori infection and peptic disease in coeliac disease. Eur J Gastroenterol Hepatol. 2000;12(12):1283-1287.
• Rostami-Nejad M, Villanacci V, Mashayakhi R, et al. Celiac disease and Hp infection association in Iran. Rev Esp Enferm Dig. 2009;101(12):850-854.
• Rostami Nejad M, Rostami K, Yamaoka Y, et al. Clinical and histological presentation of Helicobacter pylori and gluten-related gastroenteropathy. Arch Iran Med. 2011;14(2):115-118.
• Destek S, Gül VO. The relationship between nonspecific duodenitis and gastritis with helicobacter pylori. Acıbadem Uni Health Sci J. 2020(3):505-509.