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Pediatric Helicobacter pylori gastropathy demonstrates a unique pattern of gastric foveolar hyperplasia
Author(s) -
Saghier Sadaf,
Schwarz Steven M.,
Anderson Virginia,
Gupta Raavi,
Heidarian Amin,
Rabinowitz Simon S.
Publication year - 2018
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12487
Subject(s) - foveolar cell , helicobacter pylori , gastritis , gastroenterology , antrum , medicine , helicobacter , gastric mucosa , stomach , spirillaceae
Objectives Helicobacter pylori ( Hp ) are the most common agents causing gastric mucosal injury worldwide. Foveolar hyperplasia is a key component of the stomach's reaction to injury. This study examines histopathologic characteristics associated with Helicobacter pylori and with non‐ Helicobacter pylori ‐associated gastropathy in children and adolescents, and compares the prevalence of foveolar hyperplasia among these disease subgroups and normal control subjects. Methods Eighty‐one gastric antral and corpus biopsies from subjects 2‐19 years of age were studied. Twenty‐two subjects with Helicobacter pylori gastritis were compared to 23 with non‐ Helicobacter pylori gastropathy and to 36 controls (normal biopsies). Foveolar length, full mucosal thickness, and the foveolar length: full mucosal thickness ratio were derived by a morphometric technique previously developed to analyze adult gastric tissue. Results Compared to controls, Helicobacter pylori gastritis demonstrated significant increases in antral foveolar length ( P < .0001), full mucosal thickness ( P < .0001), as well as corpus foveolar length ( P < .05) and corpus full mucosal thickness ( P < .05). Non‐ Helicobacter pylori ‐associated gastropathy also was characterized by increased antral foveolar length ( P < .0001) and full mucosal thickness ( P < .001) but corresponding corpus measurements did not differ from controls. Antral foveolar length in non‐ Helicobacter pylori gastropathy was increased, when compared to Helicobacter pylori gastritis ( P < .05), while corpus values were not. The non‐ Helicobacter pylori gastropathy group demonstrated increased antral foveolar length: full mucosal thickness ratios, compared with Helicobacter pylori gastritis ( P < .001) and with normal controls ( P < .0001). Discussion An objective, quantitative approach to measuring foveolar hyperplasia in adults was successfully applied to pediatric biopsies and yielded a richer characterization of gastric pathology in children. Foveolar hyperplasia appears to be a generalized phenomenon in the presence of pediatric Helicobacter pylori gastritis but is limited to the antrum in non‐ Helicobacter pylori gastropathy.