Journal of the Korean Pediatric Society 1995;38(8):1069-1076.
Published online August 15, 1995.
Clinical and Histologic Findings and their Correlations in Children with Nodular Gastritis
Ki Moon Cha2, Gi Euin Won2, Hann Tchah2, Ho Jin Park2, Mi Kyoung Shin1
1Department of Pathology, Seoul Red Cross Hospital, Seoul, Korea
2Department of Pediatrics, Seoul Red Cross Hospital, Seoul, Korea
결절성 위염의 임상적 및 조직학적 소견
차기문2, 원지은2, 차한2, 박호진2, 신미경1
1서울적십자병원 병리과
2서울적십자병원 소아과
Abstract
Purpose
: Recently, a wide application of gastrofiberscopy in the pediatric group have revealed that nodular gastritis is an unique disease in children and associated with Helicobacter pylori. The aim of this prospective study was to investigate the clinical and histologic features in children with nodular gastritis, and to assess corelation between both.
Methods
: During a period of 44 months(May 1991-December 1994), we investigated clinical, endoscopic and histologic features of 59 consecutive patients diagnosed as having nodular gastritis at pediatric department of Seoul Red Cross Hospital. In 49 children with nodular gastritis, endoscopic biopsy specimens were stained with hematoxylin & eosin and Giemsa's stain, and were graded following the criteria outlined by Prieto et al.
Results
: 1) The mean duration of abdominal pain was 42 weeks. Th efrequencies of awakening pain and hunger pain were 38.9% and 28.8%, respectively and those of vomiting, hematemesis or melena and family history of peptic ulcer or chronic gastritis were 32.3%, 20.3% and 15.3%, respectively. 2) Major coexistent abnormal findings wer duodenitis(20.3%), duodenal lymphoid hyperplasia(16.9%), duodenal ulcer(8.5%), strong positive Mantouxest (induration>15mm)(8.5%), anemia without evidence of upper G-I bleeding(8.5%), reflux esophagitis(5.1%), gastric ulcer(1.7%), Henoch-Schoenlein purpura(1.7%) and chronic hepatitis B(5.1%). 3) Histologic study showed the frequency of H.pylori colonization in 83.7% active chronic gastritis in 87.8% and non active chronic gastritis in 12.2% of the children with nodular gastritis. Significant corelation was observed between H.pylori colonization score and histologic score(p<0.001, r=0.6196). And no significant differences between H.Pylori colonization socre ad histologic score were detected among the different groups regarcolonization duration of abdominal pain, awakening pain, vomiting, and hematemesis or melena. 4) Treatment with amoxicillin and tripotassium dicitratobismuthate(De-Nol) resulted in disappearance of adominal pain within 2 weeks(62.9%), improvement of gastritis(68.8%) and clearance of H.pylori(75.0%).
Conclusion
: Our study observed a clear correlation between the degree of H.pylori colonization and histologic categories(p<0.001), but there wasn't any association between clinical features and histologic findings. Treatment with amoxicillin and De-Nol eradicated H.pylori and improved gastritis. Further active endoscopic investigations in children with nodular gastritis are needed to elucidate the role of associated disorders.
Key Words: Nodular gastritis, Helicobacter pylori, Children


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