Abstract
Campylobacter pylori(CP) has been isolated from the human gastric mucosa and associated with gastritis and peptic ulcer disease. Most reports have been described in adults. We have initiated a prospective study in which we used histological stains (acridine orange, Warthin Starry silver), scanning and transmission electron microscopy, culture and urease production to identify CP in antral and duodenal biopsies obtained from children undergoing upper gastrointestinal endoscopy for chronic epigastric pain. Complete evaluation has been obtained on 12 children whose plasma gastrin and pepsinogen levels were normal. Six of them were judged to be infected with CP on the basis of histological stains, elecron microscopy, and culture of antral and duodenal biopsies. In the CP positive children, gastric mucosa appeared endoscopiically normal, but showed histologically moderate to severe inflammatory changes. CP was also detected in the duodenal mucosa of 3 of these patients whose endoscopic appearances revealed either micronodular aspect or mucosal erythema. The presence of CP in the duodenal bulbs did not involve areas of gastric metaplasia. Five CP positive patients were treated with amoxycillin(AMX)for 4 wks, 1 for 2 wks. Resolution of symptoms, and eradication of CP as demonstrated in biopsy specimens taken 15 days after discontinuation of therapy, occurred only in those treated for 4 wks.
Conclusions: All children with chronic epigastric pain should be evaluated for the presence of CP in the gastric mucosa in spite of normal endoscopic appearances. The organism should be also determined in the duodenal mucosa; though the association between CP and gastric metaplasia has been reported in adults, our data on children do not support it. Further studies should be done in order to clarify the role of CP in the duodenum of children. Our preliminary results suggest the efficacy of a 4-wk course with AMX in eradicating the organism.
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Bonamico, M., Chiesa, C., Carpino, F. et al. 70 CAMPYLOBACTER PYLORI IN CHILDREN.A PRELIMINARY STUDY. Pediatr Res 24, 416 (1988). https://doi.org/10.1203/00006450-198809000-00093
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DOI: https://doi.org/10.1203/00006450-198809000-00093