Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study

Kallirroi Kotilea¹, Claudio Romano², Erasmo Miele³, Angelika Kindermann⁴, Yael Dolstra⁵, Zrinjka Misak⁶, Vaidotas Urbonas⁷, Josef Sykora⁸, Pedro Urruzuno⁹, Alexander Krauthammer^{10

11}, Maria Rogalidou¹², Konstantina Dimakou¹², Tsili Zangen¹³, Eleftheria Roma¹⁴, Aglaia Zellos¹⁴, María Luz Cilleruelo¹⁵, Meline M'Rini¹, Patrick Bontems¹, Yasin Sahin¹⁶, Marta Tavares¹⁷, Tatevik Shahinyan¹⁸, Biljana Vuletic¹⁹, Nicolas Kalach²⁰, Michal Kori^{21

22}; ESPGHAN H. pylori special interest group

Affiliations

¹ Université Libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.
² Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology, University of Messina, Messina, Italy.
³ Department of Translational Medical Science, Section of Paediatrics University of Naples "Federico II", Naples, Italy.
⁴ Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Paediatric Gastroenterology, Amsterdam, The Netherlands.
⁵ Paediatric Division, Kaplan Medical Centre, Rehovot, Israel.
⁶ Referral Centre for Paediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
⁷ Clinic of Children's Diseases of Vilnius University Faculty of Medicine, Vilnius, Lithuania.
⁸ Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic.
⁹ Paediatric Gastroenterology Unit, Hospital 12 de Octubre, Madrid, Spain.
¹⁰ Paediatric Gastroenterology Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
¹¹ Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹² Division of Gastroenterology & Hepatology, 1st Pediatrics Department, University of Athens, Agia Sofia Children's Hospital, Athens, Greece.
¹³ Pediatric Gastroenterology Division, Wolfson Medical Center, Holon, Israel.
¹⁴ Division of Paediatric Gastroenterology and Hepatology, Mitera Children's Hospital, Athens, Greece.
¹⁵ Pediatric Gastroenterology Unit, Puerta de Hierro Majadahonda Hospital, Madrid, Spain.
¹⁶ Division of Pediatric Gastroenterology, Gaziantep Islam Science and Technology University Medical Faculty, Gaziantep, Turkey.
¹⁷ Pediatric Gastroenterology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário de Santo António, Porto, Portugal.
¹⁸ Arabkir Institute of Child and Adolescent Health, Yerevan, Armenia.
¹⁹ Faculty of Medical sciences Department of Pediatrics, University of Kragujevac, Kragujevac, Serbia.
²⁰ Saint Antoine Paediatric Clinic, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University, Lille, France.
²¹ Paediatric Gastroenterology, Kaplan Medical Centre, Rehovot, Israel.
²² Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

PMID: 38790089
DOI: 10.1111/hel.13092

Multicenter Study

Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study

Kallirroi Kotilea et al. Helicobacter. 2024 May-Jun.

. 2024 May-Jun;29(3):e13092.

doi: 10.1111/hel.13092.

Authors

Affiliations

¹ Université Libre de Bruxelles, Hôpital Universitaire de Bruxelles, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium.
² Paediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology, University of Messina, Messina, Italy.
³ Department of Translational Medical Science, Section of Paediatrics University of Naples "Federico II", Naples, Italy.
⁴ Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Paediatric Gastroenterology, Amsterdam, The Netherlands.
⁵ Paediatric Division, Kaplan Medical Centre, Rehovot, Israel.
⁶ Referral Centre for Paediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
⁷ Clinic of Children's Diseases of Vilnius University Faculty of Medicine, Vilnius, Lithuania.
⁸ Faculty of Medicine in Pilsen, Charles University in Prague, Prague, Czech Republic.
⁹ Paediatric Gastroenterology Unit, Hospital 12 de Octubre, Madrid, Spain.
¹⁰ Paediatric Gastroenterology Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel.
¹¹ Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹² Division of Gastroenterology & Hepatology, 1st Pediatrics Department, University of Athens, Agia Sofia Children's Hospital, Athens, Greece.
¹³ Pediatric Gastroenterology Division, Wolfson Medical Center, Holon, Israel.
¹⁴ Division of Paediatric Gastroenterology and Hepatology, Mitera Children's Hospital, Athens, Greece.
¹⁵ Pediatric Gastroenterology Unit, Puerta de Hierro Majadahonda Hospital, Madrid, Spain.
¹⁶ Division of Pediatric Gastroenterology, Gaziantep Islam Science and Technology University Medical Faculty, Gaziantep, Turkey.
¹⁷ Pediatric Gastroenterology Unit, Centro Materno Infantil do Norte, Centro Hospitalar e Universitário de Santo António, Porto, Portugal.
¹⁸ Arabkir Institute of Child and Adolescent Health, Yerevan, Armenia.
¹⁹ Faculty of Medical sciences Department of Pediatrics, University of Kragujevac, Kragujevac, Serbia.
²⁰ Saint Antoine Paediatric Clinic, Saint Vincent de Paul Hospital, Groupement des Hôpitaux de l'Institut Catholique de Lille (GHICL), Catholic University, Lille, France.
²¹ Paediatric Gastroenterology, Kaplan Medical Centre, Rehovot, Israel.
²² Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

PMID: 38790089
DOI: 10.1111/hel.13092

Abstract

Background: Helicobacter pylori may be found during upper gastrointestinal endoscopy (UGE) performed to diagnose celiac disease (CeD), inflammatory bowel disease (IBD), and eosinophilic esophagitis (EoE). We aimed to describe the frequency of H. pylori in children undergoing UGE for CeD, IBD, and EoE and the number of children receiving eradication treatment.

Materials and methods: A retrospective multicenter study from 14 countries included pediatric patients diagnosed with CeD, IBD, and EoE between January 2019 and December 2021.

Data collected: age, gender, hematologic parameters, endoscopic, histologic, and H. pylori culture results, and information on eradication treatment.

Results: H. pylori was identified in 349/3890 (9%) children [167 (48%) male, median 12 years (interquartile range 8.1-14.6)]. H. pylori was present in 10% (173/1733) CeD, 8.5% (110/1292) IBD and 7.6% (66/865) EoE patients (p = NS). The prevalence differed significantly between Europe (Eastern 5.2% (28/536), Southern 3.8% (78/2032), Western 5.6% (28/513)) and the Middle East 26.6% (215/809) [odds ratio (OR) 7.96 95% confidence interval (CI) (6.31-10.1) p < 0.0001]. Eradication treatment was prescribed in 131/349 (37.5%) patients, 34.6% CeD, 35.8% IBD, and 56.1% EoE. Predictors for recommending treatment included erosions/ulcers [OR 6.45 95% CI 3.62-11.47, p < 0.0001] and nodular gastritis [OR 2.25 95% CI 1.33-3.81, p 0.003]. Treatment rates were higher in centers with a low H. pylori prevalence (<20%) [OR 3.36 95% CI 1.47-7.66 p 0.004].

Conclusions: Identifying H. pylori incidentally during UGE performed for the most common gastrointestinal diseases varies significantly among regions but not among diseases. The indications for recommending treatment are not well defined, and less than 40% of children received treatment.

Keywords: Helicobacter pylori; children; eradication treatment; incidental diagnosis.

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References

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Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study

Affiliations

Helicobacter pylori infection found during upper endoscopy performed for the diagnosis of celiac, inflammatory bowel diseases, and eosinophilic esophagitis: A multicenter pediatric European study

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous