Broide E, et al. – The specialists examined children with chronic gastritis, in order to determine H. pylori status and celiac disease (CD). They suggested lymphoid follicles as a feature of H. pylori–negative gastritis in children independent of their CD status.

Methods

• In this study, demographic, clinical, endoscopic, and histologic features of children who underwent elective esophagogastroduodenoscopy were reviewed.
• With the aid of Updated Sydney System, gastric biopsies from the antrum and corpus of the stomach were graded.
•  H. pylori presence was defined by hematoxylin and eosin, Giemsa, or immunohistochemical staining and urease testing.

Results

• 184 children (61.9% female) met the study criteria with a mean age of 10 years.
• 122 (66.3%) patients had chronic gastritis.
• 74 (60.7%) were H. pylori–negative.
• Evaluations revealed that children with H. pylori–negative gastritis were younger (p=0.003), were less likely to present with abdominal pain (p=0.02), and were mostly of non–Arabic origin (p=0.011).
• Nodular gastritis was found to be less prevalent in H. pylori–negative gastritis (6.8%) compared with H. pylori–positive gastritis (35.4%, p<0.001).
• In the H. pylori–positive group, the grade of mononuclear infiltrates and neutrophil density was more severe (p<0.001). 
• Pan–gastritis and lymphoid follicles were associated most commonly with H. pylori. 
• In 51.3% of H. pylori–negative patients, lymphoid follicles were demonstrated.
• The presence or absence of CD was not associated with histologic findings in H. pylori–negative gastritis.