الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 215 |  |  |
| | | from | 215 | | |
Abstract
Helicobacter pylori colonizes almost half of world’s population and amongst these only a minority of them develop associated clinical disease. The infection is mainly acquired during childhood and its prevalence tends to be higher in developing countries than in developed ones. (2) Extra gastric diseases are also associated with H.pylori infections including micronutrients deficiencies. (4) The aim of this study was to investigate iron, zinc and copper status in symptomatic children with H.pylori infection and correlate their serum levels with the degree of the associated gastritis, as well as to evaluate the effect of H.pylori treatment on these parameters. This study was carried out upon seventy children with symptoms referable to the upper gastrointestinal tract. All patients underwent upper gastrointestinal endoscopy to diagnose the presence of H.pylori and to assess the gross and histopathologic gastric findings. H.pylori infection was defined as the presence of both histologicallyproven micro-organism and positive rapid urease test. Children were divided into two groups: forty with H.pylori infection (H.pyloripositive gastritis) and thirty without infection (H.pylori-negative gastritis). Twenty healthy age-and-sex matched children were chosen as controls. All children were subjected to the following: A) Clinical assessment including anthropometric measurments (weight, height and BMI z-scores) . B) Laboratory investigations: 1) Serum hemoglobin concentration (HB). 2)Serum ferritin level. 3) Serum soluble transferrin receptors(sTFR) concentration. 4)Serum zinc level. 5)Serum copper level. Upper gastrointestinal endoscopy was performed to symptomatic children. H.pylori positive patients received the triple therapy (clarithromycin, metronidazole and proton pump inhibitors) for two weeks. Three months after termination of the treatment, the previous laboratory and histological data were reassessed. RESULTS: Clinical Findings: - Mean value of of weight z-core was significantly lower in H.pylori positive than H.pylori negative cases . - Abdominal pain was the commonest manifestation. It represent 87.5% and 80% in infected and non-infected patients, respectively. Endoscopic features: - Erythema was the most common feature. It was found in 31(77.5%) of H.pylori positive and in 21(70%) of H.pylori negative cases. - Fine nodularity was found in 12(30%) of children with H.pylori positive and in 3 (10%) of children with H.pylori negative cases. - Coarse nodularity, ulcers and cobblestone were found only in children with H.pylori positive gastritis. Histopatholgical features: - Inactive chronic gastritis was found in 32(80 %) of children with H.pylori positive and in 24 (80%) of children with H.pylori negative. - Mild inactive chronic gastritis was found in 15(46.88%) of children with H.pylori positive and in 18(75%) of H.pylori negative cases. - Moderate inactive chronic gastritis was found in 15 (46.88%) of children with H.pylori positive and 6 (25.00%) of H.pylori negative cases. - Severe inactive chronic gastritis was found only in children with H.pylori positive gastritis 2 (6.25%). - chronic active gastritis was found in 8(20%) of children with H.pylori positive and in 6 (20%) of H.pylori negative cases. - Mild chronic active gastritis was found only in 3(50%) of H.pylori negative cases. - Moderate chronic active gastritis was found in 8 (100%) in children with H.pylori positive and in 3 (50.00%) of H.pylori negative cases. - No severe chronic active gastritis was found in both groups. A) After treatment: - Normal endoscopic finding was observed in 16(40%) of the patients. - The percentage of nodularity was improved than pre-treatment (11/40,27.5% vs.26/40, 65%), respectively. - Absence of ulcers and cobblestones. - Histological findings (inflammation and activity) were significantly improving. Laboratory Results: - Mean value of hemoglobin was significant lower in H.pylori positive patients than controls, with no significant difference between infected and non-infected children. This level significantly increased after treatment. - Mean value of serum ferritin was significantly lower in patients with H.pylori positive compared to patients with H.pylori negative and controls. This level significantly increased after treatment. - Mean value of serum sTfR was significantly higher in H.pylori positive compared to H.pylori negative patients and controls. This level significantly decreased after treatment. - Mean value of serum zinc was significant lower in H.pylori positive patients than controls, with no significant difference between infected and non-infected children. This level significantly increased after treatment. - No significant difference in serum copper level between the three groups. No change of it is level was observed after treatment. Correlation analysis: Correlation with the severity of histopathologic abnormalities (inflammation and activity) revealed: - A weak significant inverse relation with hemoglobin and zinc levels and significant inverse relation with serum ferritin concentrations. - A significant positive relation with sTfR serum concentrations. - No correlation with other variables: age, duration of the disease, anthropometric measurements as well as serum copper concentration.