Endoscopic and histopathological findings in children with growth retardation.

OBJECTIVE

The study aimed to describe the clinical characteristics, endoscopic and histopathological findings of children admitted to the paediatric gastroenterology outpatient clinic for growth retardation.

METHODS

The study was carried out with 90 patients aged 2-18 years who presented to our paediatric gastroenterology outpatient clinic with complaints of growth retardation and underwent oesophagogastroduodenoscopy (EGD) because growth retardation persisted despite adequate caloric support (at least 3 months).

RESULTS

The mean age of the patients was 11.11±4.27 years, 56 (62.2%) were female and 52 (57.8%) were under 12 years of age. Of the patients, 36.7% had mild, 47.8% moderate and 15.6% severe acute malnutrition, 22.2% stunting and 7.8% severe stunting. Associated dyspeptic symptoms were present in 34 (37.8%) patients and celiac antibodies were positive in 20 (22.2%) patients. Iron deficiency was present in 28.9% and B12 deficiency in 41.1% of the patients. The most common endoscopic findings were pangastritis (88.9%), duodenitis (61.1%), bile reflux (35.6%) and bulbitis (31.1%). Chronic Helicobacter pylori (H. pylori) gastritis was found in 72.2%, celiac disease in 20.0% and reflux oesophagitis in 17.8% of the patients. No association was found between chronic H. pylori gastritis and iron deficiency anaemia and vitamin B12 deficiency (p=0.90, p=0.89). There was no association between chronic H. pylori gastritis and height-for-age, weight-for-height and BMI z scores (0.31, 0.57, 0.43).

CONCLUSION

In this study, positive endoscopic findings were found in all children with persistent growth retardation despite adequate caloric support, even in the absence of accompanying dyspeptic symptoms. More studies evaluating the usefulness of endoscopy in children with growth retardation are needed.