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1Gastroenterology and Nutrition, Hospital de Pediatria, Guadalajara, Mexico; 2Instituto de Nutrición Humana, U de G, Guadalajara, Mexico.
The association between H. pylori (HP) infection and iron deficiency in children with refractory anemia has been reported. The mechanisms of iron deficiency are not completely understood; however, the high prevalence of iron deficiency and HP infection make this association an important issue.
To evaluate the iron nutritional status in children with recurrent abdominal pain (RAP) and gastritis associated -or not- to HP infection.
Design: Cross-sectional. Inclusion: 6-15 years, RAP, histological gastritis. Sample: Consecutive cases with RAP in a two year period (2004-05). Dependent variable: Iron nutritional status. Independent variables: Gastritis + HP and gastritis without HP. Protocol: RAP protocol including panendoscopy and biopsies of the upper GI tract. The cases with histological gastritis (Dixon criteria) were classified according to the presence or absence of HP. Complete blood count, ferritin, serum iron, transferrin, % saturation and total iron-binding capacity were evaluated in all cases. Statistics: χ2, Student t.
n = 63, mean age 9.9 years. 19 (30.2%) had HP and 44 (69.8%) had not. Moderate and severe acute gastritis occurred more frequently in cases with HP (P = 0.03, OR 4.3, CI 0.96-20.3); moderate and severe chronic gastritis occurred more frequently in cases with HP (P < 0.001, OR 30, CI 3.7-64.3). 26% of cases with HP had lower hemoglobin and hematocrit (P = 0.001) and 21% had lower values of MCV, MCH and MCHC (P = 0.04). 31.5% of cases with HP had lower ferritin values than the group without HP (P = 0.002). No differences were observed in serum iron, transferrin saturation and iron-binding capacity.
A significant proportion of cases with gastritis and HP had a more severe histological picture than the group without the HP infection. From one fifth to one fourth of cases with HP had an abnormal iron nutritional status compared with the group without it.
© 2006 Lippincott Williams & Wilkins, Inc.
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