Background: The role of Helicobacter pylori (HP) as a cause of iron deficiency anemia (IDA) in childhood and the impact of HP eradication on IDA are controversial.
Aims: 1.HP prevalence in children undergoing UGE for IDA compared to non-IDA. 2. Impact of HP eradication on IDA parameters.
Methods: Chart review of children referred for UGE 2004 -2010, excluding celiac disease, IBD, interventional procedures, bleeding, incomplete records . Study group - children referred with IDA with/without other symptoms. Control group - other indications. Data extraction : IDA parameters, HP (rapid-urease test /gastric biopsy), treatment, evidence of HP eradication, F/U of IDA parameters. Endpoints: 1. HP in the study and control groups. 2. IDA parameters in IDA+HP compared with IDA + no HP. 3. IDA parameters in eradicated versus non-eradicated patients.
Results: 104 study and 787 controls were included , 52%/ 44% males, age 9.0±5.5/ 9.7±5.0 yrs, respectively. HP was found in 38/104 (36.5%) of the study, and 147/787 (18.7%) of the control groups, respectively (p<0.01). Within the study group baseline ferritin levels were lower in HP-positive than HP-negative patients (p=0.02). Eradication rate was 68%. In a higher rate of eradicated than non-eradicated patients hemoglobin increased > 2 gr% ( p=0.02).
Conclusions: In patients referred to UGE for IDA evaluation, HP is a significant cause , and is more prevalent than in non-IDA patients. Iron deficiency is more severe in HP than in non-HP IDA patients. Hemoglobin level significantly improves in eradicated versus non-eradicated patients.
