scholarly journals Pathobiology ofHelicobacter pyloriInfection in Children

1999 ◽  
Vol 13 (7) ◽  
pp. 599-603 ◽  
Author(s):  
Robert H Riddell
Keyword(s):  
Intestinal Metaplasia ◽  
Pediatric Population ◽  
Paediatric Population ◽  
Lymphoid Hyperplasia ◽  
Host Responses ◽  
Low Grade ◽  
Cell Axis ◽  
Age Related ◽  
H Pylori ◽  
Time Required

In the paediatric population, the associations ofHelicobacter pyloriwith gastritis, gastric ulcer, duodenitis and duodenal ulcer, and with duodenal gastric surface metaplasia and disorders of the D cell-G cell axis resulting in hypergastrinemia, are well established and in many ways resemble their counterparts in adults. Eradication ofH pyloriinvariably results in the reversal of these diseases with time. There are also suggestions that gastric surface metaplasia is more extensive in children withH pylori, and may be the site of duodenalH pyloriinfection and associated duodenal erosions or ulcers. There is no consensus as to whetherH pyloriin children is more or less severe than in adults. In one paediatric cohort,H pyloriwas associated with increased intensity of inflammation, while other studies suggest that acute inflammation may be less intense in children overall but that chronic inflammation may be increased in intensity, including lymphoid hyperplasia, which in turn may correlate with endoscopic nodularity. Lymphoid hyperplasia and nodular gastritis appear to be more frequent in children than in adults and usually regress followingH pylorieradication. However, in children, other diseases or morphological abnormalities, including some loss of glands (atrophy), occasionally intestinal metaplasia, lymphoproliferative diseases including low grade mucosal-associated lymphoid tissue lymphoma, lymphocytic gastritis and hypertrophic gastritis/Menetrier’s disease, are much less frequently associated withH pylorithan in adults. Other associations are rarely seen in children, primarily because the time required for these to develop takes the individual to adulthood; for example, while intestinal metaplasia occurs in the pediatric population, the complications of adenoma/dysplasia and carcinoma are rare. In adults, inflammatory and hyperplastic polyps, atrophic gastritis and pernicious anemia, and in some patients granulomas (granulomatous gastritis), may also be associated withH pyloriinfection. Greater awareness of the spectrum of diseases associated withH pylorimay well lead to their increased recognition in the paediatric population. Some diseases, particularly Crohn’s disease, but also human immunodeficiency virus infection, have a negative association withH pylorithat appears not to be simply a result of the excess antibiotic therapy that these patients receive. These variations in association and reactions toH pylori, some of which are age-related, may allow the different host responses toH pylorithat occur in humans to be examined.

scholarly journals Non-Helicobacter pylori Gastric Intestinal Metaplasia in Children: A Series of Cases and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Sandra Mabel Camacho-Gomez ◽  
Anas Bernieh ◽  
Ali G. Saad ◽  
Neelesh Ajit Tipnis
Keyword(s):  
Helicobacter Pylori ◽  
Intestinal Metaplasia ◽  
Pediatric Population ◽  
Duodenogastric Reflux ◽  
Clinical Implications ◽  
Review Of The Literature ◽  
Gastric Intestinal Metaplasia ◽  
The Individual ◽  
Time Required

In the pediatric population, Gastric Intestinal Metaplasia (GIM) is a finding with unknown frequency and, more importantly, unknown clinical implications. The relationship between Helicobacter pylori (HP) infection and GIM is well documented, as well as an association between duodenogastric reflux and GIM. We present two cases of pediatric patients with GIM along with a review of the literature. The diagnosis of GIM may have adverse clinical implications and should be made with caution in a child. The association of GIM and adenoma/dysplasia and carcinoma is rarely seen in children, primarily because the time required for these to develop takes the individual into adulthood. Treatment, long-term consequences, and surveillance protocols are not well established in the pediatric population. Studies to evaluate the long-term natural history, treatment, and surveillance protocols in children with GIM are needed.

scholarly journals Chronic gastritis and precancerous diseases of the stomach: Is there a chance of a correct diagnosis?

2021 ◽  
Vol 13 (1) ◽  
pp. 85-102
Author(s):  
Aleksandr V. Tryapitsyn ◽  
Vladimir A. Malkov ◽  
Emil M. Gasanov ◽  
Ilya Belyakov
Keyword(s):  
Gastric Mucosa ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Correct Diagnosis ◽  
Intraepithelial Neoplasia ◽  
Autoimmune Gastritis ◽  
Low Grade ◽  
Adequate Treatment ◽  
H Pylori ◽  
Almost All

AIM: The purpose of the study is to investigate the occurrence of the main forms of chronic gastritis, metaplastic and dysplastic changes in the gastric mucosa, the degree of their severity, and to assess their potential risk for the development of gastric cancer. MATERIALS AND METHODS: The study involved 2982 patients who underwent esophagogastroduodenoscopy with a standard biopsy of the gastric mucosa for morphological assessment and bacterioscopy. If autoimmune gastritis was suspected, an additional serological diagnosis was performed. When detecting intestinal metaplasia of the gastric mucosa as well as neoplastic changes according to the histological report, the description of this report was analyzed in order to identify possible equivalents in the macroscopic description of the mucous membrane. RESULTS: Out of 2982 histological studies of gastric mucosa biopsies, 1273 cases (42.7%) were found to contain H. pylori contamination. In 726 cases (24.3%), intestinal metaplasia. 66 biopsies (2.21%) showed the presence of low-grade intraepithelial neoplasia of the mucosa, 2 biopsies showed indeterminate neoplasia and 4 biopsies showed high-grade neoplasia. In 3 out of the total number of the samples, intravascular gastric adenocarcinoma was detected. In 168 cases (5.6%), gastritis was detected with predominant inflammation of the fundal region characteristic of autoimmune gastritis. In 286 biopsies (10.6%), inflammatory and/or atrophic changes and/or metaplastic changes were preserved, which, as a rule, did not have high activity and pronounced inflammation. In the remaining 1279 cases (42.9%), there was no significant inflammation or atrophic changes. The analysis of endoscopic findings showed that the detectability of intestinal metaplasia of the gastric mucosa without a biopsy study was 13.3%. DISCUSSION OF THE RESULTS: According to the results of the conducted research and analysis, it can be stated that at present, the correct diagnosis of chronic gastritis with the establishment of the etiological factor, prognosis and risks of stomach cancer development is practically not feasible within the modern health care system. This not only deprives a doctor of the opportunity to make a correct diagnosis and prescribe adequate treatment to a patient, but also makes almost all cascades of carcinogenesis, including early cancer, invisible.

scholarly journals Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

2012 ◽  
Vol 49 (1) ◽  
pp. 52-55 ◽  
Author(s):  
Judite Dietz ◽  
Jane Maria Ulbrich-Kulcynski ◽  
Katia Elisabete Pires Souto ◽  
Nelson Guardiola Meinhardt
Keyword(s):  
Bariatric Surgery ◽  
Intestinal Metaplasia ◽  
Gastrointestinal Endoscopy ◽  
Lymphoid Hyperplasia ◽  
Upper Gastrointestinal Endoscopy ◽  
Obese Patients ◽  
Digestive Endoscopy ◽  
Upper Digestive Endoscopy ◽  
H Pylori ◽  
Upper Gastrointestinal

CONTEXT: The prevalence of obesity has been increasing in modern society. Roux-en-y gastric bypass is a bariatric surgery that involves the exclusion of significant part of the stomach. Atrophy, intestinal metaplasia and gastric cancer have been associated with infection by Helicobacter pylori. OBJECTIVES: To evaluate the presence of endoscopy findings and histological changes in morbid obese patients for the presence of inflammatory cells, inflammatory activity, lymphoid hyperplasia, H. pylori infection, atrophy and intestinal metaplasia in the gastric mucosa. METHODS: Upper digestive endoscopy and gastric histopathological were studied in 126 obese patients in the preoperative evaluation for bariatric surgery. RESULTS: Upper digestive endoscopy abnormalities were diagnosed in 73/126 (57.9%) patients. In three patients (2.4%) the upper gastrointestinal endoscopy diagnosed gastric ulcer and one patient (0.8%) had duodenal ulcer. The histopathological from gastric biopsies of these obese patients showed 65.1% of mucosa inflammation, inflammatory activity in 50.0%, infection by H. pylori in 53.2%, lymphoid hyperplasia in 50.0% and atrophy and/or intestinal metaplasia in 16.7%. CONCLUSIONS: In present study, with routine preoperative upper gastrointestinal endoscopy and histopathological examination, were detected 57.9% patients with endoscopy abnormalities, high prevalence of infection by H. pylori (53%) and 16.7% of gastric atrophy and/or intestinal metaplasia.

Histologic Changes of the Gastric Mucosa Associated With Primary Gastric Lymphoma in Endoscopic Biopsy Specimens

2000 ◽  
Vol 124 (11) ◽  
pp. 1628-1631
Author(s):  
Julián Arista-Nasr ◽  
Roberto Herrera-Goepfert ◽  
Minerva Lazos-Ochoa ◽  
Raúl Pichardo
Keyword(s):  
Gastric Mucosa ◽  
Intestinal Metaplasia ◽  
Gastric Lymphoma ◽  
Endoscopic Biopsy ◽  
Glandular Epithelium ◽  
Low Grade ◽  
Lymphoid Follicles ◽  
Primary Gastric Lymphoma ◽  
Endoscopic Biopsies ◽  
H Pylori

Abstract Context.—Recently, we have observed intestinal metaplasia, atrophy, and dysplasia in the mucosa adjacent to primary gastric lymphoma (PGL) in gastrectomy specimens. Objective.—To determine the frequency and type of epithelial disorders at the histopathologic level in the mucosa adjacent to PGL in endoscopic specimens. Design.—We studied 54 endoscopic biopsies from patients harboring PGL. We searched for the following morphologic changes in the gastric mucosa: intestinal metaplasia; atrophy; dysplasia; epithelial erosion; and atypical regeneration of the glandular epithelium. Other nonepithelial findings such as lymphoid follicles, Helicobacter pylori, and lymphoma grade, were also recorded. For comparative purposes, 50 endoscopic biopsies with gastric adenocarcinoma and 50 biopsies with chronic gastritis associated with H pylori infection were also studied. Results.—The 54 biopsies included 28 (52%) low-grade and 26 (48%) high-grade PGLs. We found intestinal metaplasia in 32 biopsies (59%), atrophy in 20 biopsies (37%), dysplasia in 2 biopsies (4%), erosion of the epithelium in 33 biopsies (61%), and atypical regenerative changes of the glandular epithelium in 10 biopsies (19%). Lymphoid follicles were found in 21 biopsies (39%), and H pylori was demonstrated in 31 biopsies (57%). When groups were compared, the frequency of epithelial changes in biopsies from patients with PGL and adenocarcinoma was similar. Intestinal metaplasia or atrophy were present in only 10% of biopsies from patients with gastritis, and dysplastic glands were not identified. Conclusions.—Biopsies from patients with PGL showed chronic damage of the gastric mucosa at diagnosis, including precancerous conditions. Intestinal metaplasia and atrophy were among the most frequent disorders, but dysplasia was also occasionally present. Endoscopists and pathologists must be acquainted with such changes and look for them in the initial biopsy, as well in subsequent samples. This practice is particularly important when reviewing biopsies from patients with low-grade mucosa-associated lymphoid tissue (MALT)-lymphomas who are eligible for eradication treatment for H pylori.

scholarly journals Endoscopic and morphological features of chronic subatrophic gastroduodenitis in children

2015 ◽  
Vol 96 (1) ◽  
pp. 42-45 ◽  
Author(s):  
E M Nikiforova ◽  
N V Malyuzhinskaya ◽  
M A Chueva ◽  
V V Alferova ◽  
E N Solov’ev
Keyword(s):  
Intestinal Metaplasia ◽  
Breath Test ◽  
Clinical Manifestations ◽  
Morphological Characteristics ◽  
Treatment Compliance ◽  
Duodenal Mucosa ◽  
Acute Stage ◽  
Low Grade ◽  
Functional Features ◽  
H Pylori

Aim. To identify the pecularities of clinical, functional features and morphological characteristics in children with subatrophic gastroduodenitis after eradication treatment.Methods. Gastrointestinal tract condition was examined in 26 children with subatrophic gastroduodenitis. Esophagogastroduodenoscopy with morphological analysis of biopsy specimens, esophageal pH test and urea breath test were performed.Results. 16 (60.7%) children reported low-grade pain, severe pain occurred in 3 (11.5%) patients, no abdominal pain was reported in 7 (27.6%) patients. A biopsy specimen was gained in 22 patients; moderate contamination with H. pylori was detected in 13 (59%) patients, severe - in 9 (41%) patients. Breath test was positive in all patients (n=26). Morphological study revealed fibrotic changes in 14 (63.6%) patients, atrophy and sclerosis lesions - in 7 (31.8%) and 17 (77.3%) patients, respectively, in addition to clear signs of inflammation. Intestinal metaplasia of the gastric mucosa was discovered in 4 (18.2%) children. Candidiasis of the stomach and duodenum was diagnosed in 7 (31.8%) children. All patients were administered standard eradication treatment. Repeated breath test after 4 weeks was positive in 9 (41%) patients, including 7 (31.8%) who were diagnosed with candidiasis by biopsy test. At 12 months, the control endoscopy performed in 19 patients: 5 patients, who failed to follow the recommendation, had marked clinical and endoscopic signs of relapse, no patients with good treatment compliance (n=14, 73.6%) had any clinical manifestations, although endoscopic signs of inflammation preserved in 9 (47.4%) children. Biopsy with histological examination was repeated in 9 patients. Signs of inflammation were significantly reduced in 6 (66.7%) patients, while the foci of atrophy, sclerosis and intestinal metaplasia retained in 2 out of 9 children. Contamination with H. pylori had significantly decreased.Conclusion. Endoscopic signs of gastroduodenal chronic inflammation correspond to the severity of morphological characteristics in the acute stage of gastroduodenitis. Children with preserved signs of intestinal metaplasia of gastric and duodenal mucosa require intensive treatment and prolonged follow-up.

scholarly journals A Retrospective Experience of Helicobacter pylori Histology in a Large Sample of Subjects in Northern Italy

Life ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 650
Author(s):  
Davide Giuseppe Ribaldone ◽  
Carlo Zurlo ◽  
Sharmila Fagoonee ◽  
Chiara Rosso ◽  
Angelo Armandi ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Large Population ◽  
Population Data ◽  
Signet Ring Cell ◽  
Current Data ◽  
Low Grade ◽  
Gastric Cardia Adenocarcinoma ◽  
Significant Difference ◽  
H Pylori ◽  
The Impact

Updated data about the prevalence of Helicobacter pylori (H. pylori) and its correlation with histological results are scarce. The aim of our study was to provide current data on the impact of H. pylori in a third-level endoscopy service. We performed a large, retrospective study analyzing the results of all histological samples of gastroscopy from the year 2019. In total, 1512 subjects were included. The prevalence of H. pylori was 16.8%. A significant difference between the prevalence in subjects born in Italy and those from eastern Europe, south America, or Africa was found (p < 0.0001, p = 0.006, and p = 0.0006, respectively). An association was found between H. pylori and active superficial gastritis (p < 0.0001). Current H. pylori and/or a previous finding of H. pylori was related to antral atrophy (p < 0.0001). Fifteen patients had low-grade dysplasia. There were no statistically significant associations with current or past H. pylori infection. One patient presented gastric cardia adenocarcinoma with regular gastric mucosa. One patient, H. pylori positive, was diagnosed with gastric signet ring cell adenocarcinoma in a setting of diffuse atrophy, without metaplasia.. Our study provides updated, solid (biopsy diagnosis and large population) data on the prevalence of H. pylori infection in a representative region of southern Europe.

scholarly journals 103 Periodontal Health and Sarcopenia: Cross-Sectional Evidence From A Cohort of 2040 Twin Volunteers

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
M B Zazzara ◽  
P M Wells ◽  
R C E Bowyer ◽  
M N Lochlainn ◽  
E J Thompson ◽  
...  
Keyword(s):  
Mixed Model ◽  
Linear Mixed Model ◽  
Frailty Index ◽  
Muscle Quality ◽  
Low Grade ◽  
Periodontal Health ◽  
Cross Sectional ◽  
Age Related ◽  
European Working ◽  
Generalised Linear Mixed Model

Abstract Introduction Periodontitis is a chronic inflammatory disease affecting the periodontium, ultimately leading to looseness and/or loss of teeth. Sarcopenia refers to age-related reduction in muscle mass and strength. Similar to periodontitis, chronic low-grade inflammation is thought to play a key role in its development. In addition, both increase in prevalence with advancing age. Despite known associations with other diseases involving a dysregulated inflammatory response, for example rheumatoid arthritis,, the relationship between periodontitis and sarcopenia, and whether they could be driven by similar processes, remains uncertain. The aim of this study was to explore the association between periodontitis and sarcopenia. Methods Observational study of 2040 adult volunteers [age 67.18 (12.17)] enrolled in the TwinsUK cohort study. Presence of tooth mobility and number of teeth lost were used to assess periodontal health. A binary variable was created to define periodontitis. Measurements of muscle strength, muscle quality/quantity and physical performance were used to assess sarcopenia. A categorical variable was created according to the European Working Group on Sarcopenia in Older People (EWGSOP2) consensus, to define sarcopenia (1: probable; 2: positive; 3: severe). Generalised linear mixed model analysis used on complete cases and age-matched (n = 1,288) samples to ascertain associations between periodontitis and sarcopenia. Results No significant association was found between periodontitis and sarcopenia in both the complete cases analysis and age-matched analysis. Results were consistent when analysis was adjusted for potential confounders including body mass index, frailty index, Mini Mental State Examination smoking, nutritional status and educational level. Conclusions This study found no significant association between periodontitis and sarcopenia in a cohort of 2040 adults. Although both periodontitis and sarcopenia have been linked to a dysregulated immune response and demonstrate an increase in prevalence with increasing age, our work is inconclusive due to the plethora of possible aetiopathogenetic pathways.

scholarly journals Helicobacter Infection and Gastric Adenoma

2021 ◽  
Vol 9 (1) ◽  
pp. 108
Author(s):  
Simone Bertz ◽  
Miriam Angeloni ◽  
Jan Drgac ◽  
Christina Falkeis ◽  
Corinna Lang-Schwarz ◽  
...  
Keyword(s):  
Intestinal Metaplasia ◽  
Clinicopathological Parameters ◽  
Consecutive Series ◽  
Gastric Adenoma ◽  
Gastric Intestinal Metaplasia ◽  
Pyloric Gland Adenoma ◽  
Hereditary Tumor Syndromes ◽  
Mucosal Changes ◽  
H Pylori ◽  
Insight Into

Background: We aimed to provide insight into the actual frequencies of gastric adenoma types and their association with gastritis status and associated mucosal changes with a focus on Helicobacter infection and the operative link on gastritis assessment (OLGA)/operative link on gastric intestinal metaplasia assessment (OLGIM) staging. Methods: From the archive of the Institute of Pathology in Bayreuth, we collected a consecutive series of 1058 gastric adenomas diagnosed between 1987 and 2017. Clinicopathological parameters retrieved from diagnostic reports included adenoma type and localization, associated mucosal changes in antrum and corpus (i.e., type of gastritis, the extent of intestinal metaplasia and atrophy), gender, date of birth, and date of diagnosis. Results: Intestinal-type adenoma was the most frequent adenoma (89.1%), followed by foveolar-type adenoma (4.3%), pyloric gland adenoma (3.4%), adenomas associated with hereditary tumor syndromes (2.8%), and oxyntic gland adenoma (0.4%). Adenomas were found in the background of Helicobacter pylori (H. pylori) gastritis in 23.9%, Ex-H. pylori gastritis in 36.0%, autoimmune gastritis in 24.8%, chemical reactive gastritis in 7.4%, and others in 0.1%. More than 70% of patients with gastric adenomas had low-risk stages in OLGA and OLGIM. Conclusions: We found a higher frequency of foveolar-type adenoma than anticipated from the literature. It needs to be questioned whether OLGA/OLGIM staging can be applied to all patients.

Evaluation of rapid test Assure® Helicobacter pylori for diagnosis of H. pylori in pediatric population

2006 ◽  
Vol 66 (2) ◽  
pp. 331-335 ◽  
Author(s):  
Ana Pelerito ◽  
Mónica Oleastro ◽  
Ana Isabel Lopes ◽  
Paulo Ramalho ◽  
José Cabral ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Pediatric Population ◽  
Rapid Test ◽  
H Pylori

scholarly journals Programmed cell death 4 (PDCD4) expression during multistep Barrett's carcinogenesis

2010 ◽  
Vol 63 (8) ◽  
pp. 692-696 ◽  
Author(s):  
Matteo Fassan ◽  
Marco Pizzi ◽  
Giorgio Battaglia ◽  
Luciano Giacomelli ◽  
Paola Parente ◽  
...  
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Intestinal Metaplasia ◽  
Negative Regulator ◽  
Pcr Analysis ◽  
Low Grade ◽  
Cytoplasmic Staining ◽  
Programmed Cell Death 4 ◽  
Columnar Metaplasia

AimTo test the contribution of programmed cell death 4 (PDCD4) tumour suppressor gene in Barrett's carcinogenesis.MethodsPDCD4 immunohistochemical expression was assessed in 88 biopsy samples obtained from histologically proven long-segment Barrett's mucosa (BM; 25 non-intestinal columnar metaplasia, 25 intestinal metaplasia (IM), 16 low-grade intraepithelial neoplasia (LG-IEN), 12 high-grade IEN (HG-IEN) and 10 Barrett's adenocarcinoma (BAc)). As controls, 25 additional samples of native oesophageal mucosa (N) were obtained from patients with dyspepsia. To further support the data, the expression levels of miR-21, an important PDCD4 expression regulator, in 14 N, 5 HG-IEN and 11 BAc samples were determined by quantitative real-time PCR analysis.ResultsPDCD4 immunostaining decreased progressively and significantly with the progression of the phenotypic changes occurring during Barrett's carcinogenesis (p<0.001). Normal basal squamous epithelial layers featured strong PDCD4 nuclear immunoreaction (mostly coexisting with weak–moderate cytoplasmic staining). Non-intestinal columnar metaplasia and intestinal metaplasia preserved a strong nuclear immunostaining; conversely, a significant decrease in PDCD4 nuclear expression was seen in dysplastic (LG-IEN and HG-IEN) and neoplastic lesions. Weak–moderate cytoplasmic immunostaining was evident in cases of LG-IEN, while HG-IEN and BAc samples showed weak cytoplasmic or no protein expression. As expected, miR-21 expression was significantly upregulated in HG-IEN and BAc samples, consistently with PDCD4 dysregulation.ConclusionsThese data support a significant role for PDCD4 downregulation in the progression of BM to BAc, and confirm miR-21 as a negative regulator of PDCD4 in vivo. Further efforts are needed to validate PDCD4 as a potential prognostic marker in patients with Barrett's oesophagus.

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