Duodenal intraepithelial lymphocytosis is common in children without coeliac disease, and is not meaningfully influenced by Helicobacter pylori infection. Issue 11 (7th April 2014)

• Record Type: Journal Article
• Authors: Guz‐Mark, A.; Zevit, N.; Morgenstern, S.; Shamir, R.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 39:Issue 11(2014)
• Page Start: 1314
• Page End: 1320
• Publication Date: 2014-04-07
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12739
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12739-abs-0001"> <title>Summary</title> <sec id="apt12739-sec-0001" sec-type="section"> <title>Background</title> <p>Increased numbers of duodenal intraepithelial lymphocytes (IELs) characterise coeliac disease (CD) but have also been described in noncoeliacs. Controversy exists regarding an association between increased IELs and infection with <italic>Helicobacter pylori</italic>, which is commonly found in children.</p> </sec> <sec id="apt12739-sec-0002" sec-type="section"> <title>Aim</title> <p>To assess the relationship between <italic>H. pylori</italic> infection and duodenal IELs in a large cohort of children, with and without CD.</p> </sec> <sec id="apt12739-sec-0003" sec-type="section"> <title>Methods</title> <p>We reviewed gastric and duodenal biopsies of children who underwent esophagogastroduodenoscopy between January 2006 and February 2013 because of either recurrent abdominal pain (RAP) or suspected CD at Schneider Children's Medical Center of Israel, a referral centre for Israel's largest Health Maintenance Organization. The duodenal IEL count and <italic>H. pylori</italic> presence in antral biopsies were determined for each specimen.</p> </sec> <sec id="apt12739-sec-0004" sec-type="section"> <title>Results</title> <p>Children with RAP (<italic>n</italic> = 693) or CD (<italic>n</italic> = 306) were included. Among children with RAP, <italic>H. pylori</italic> was present in 33.8%. The mean IEL count in the <italic>H. pylori</italic> positive RAP group was 17.8(±8.8)/100 enterocytes, vs. 15.8(±8.3) in the <italic>H. pylori</italic> negative patients (<italic>P</italic> = 0.004). Increased IEL counts (≥25 IELs/100 enterocytes) were found in 15.7% of <italic>H. pylori</italic> negative, noncoeliac children. Among children with CD, there was no significant difference in IEL counts according to <italic>H. pylori</italic> status: 73.1(±26.1) vs. 72.6 (±26.5) in <italic>H. pylori</italic> positive and negative patients respectively.</p> </sec> <sec id="apt12739-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Our study suggests that slightly elevated duodenal intraepithelial lymphocyte counts are common in the paediatric population. <italic>Helicobacter pylori</italic> infection has no major influence on the intraepithelial lymphocyte counts in children with recurrent abdominal pain or children with coeliac disease.</p> </sec> </abstract>