The clinical and histological spectrum of esophagitis in pediatrics. Some keys to its links to gastritis.

UNLABELLED: The purpose of our study was to assess the clinical and histological spectrum of esophagitis, seeking possible links between esophagitis and gastritis particularly Helicobacter pylori-associated, in pediatric patients.

MATERIAL AND

METHODS

We retrospectively studied 66 sequential and 63 gastric biopsies from 66 patients fulfilling the histological diagnosis of "esophagitis". Cases were arranged in two groups: G1 (H. pylori negative): N = 44 (27 m; 17 f), mean age 7.3 y (range 7-9 m-18 y) and G2 (H. pylori positive): N = 22 (16 f; 6 m), mean age 12.8 y (range 7-16 y).

RESULTS

The bases for performing endoscopy and biopsies were as follows: in G1 (N44) symptoms of gastroesophageal reflux (GER) in 24 cases and non-GER in 20 cases; in G2 (N = 22): symptoms of GER in 13 and non-GER in 9 cases. Esophageal endoscopic findings for G1 patients included: normal mucosa 39; esophagitis 3; congestive mucosa and esophagitis 1 each. Stomach endoscopic findings for G1 patients were normal mucosa 29; nodular antrum 7; congestive mucosa 4; ulceration 2; unknown 2. G2 children revealed nodular antrum 19; congestive antrum 2; normal mucosa 1. Histology of esophageal biopsies in G1 was esophagitis grade 1,35; grade 2,4; grade 3, 4, and grade 5, 1. G2 showed esophagitis grade 1,20, and grade 2,2. The histologic findings of the gastric biopsies were as follows: G1 (N = 41): normal mucosa 23; mild chronic gastritis 6; mucus depletion in the superficial 5; mild acute gastritis 3; hemorrhage 1; insufficient tissue 3. G2: chronic gastritis associated with H. pylori with or without follicular hyperplasia 21; mild gastritis 1.