ASSOCIATION OF H. PYLORI WITH ANTRAL NODULARITY AMONG CHILDREN WITH RECURRENT ABDOMINAL PAIN
AK Sharma*, KK Prasad**, CK Nain***, BR Thapa****
Department of Superspeciality of Gastroenterology, Post. Graduate Institute of Medical Education & Research, Chandigarh, India. *, Department of Superspeciality of Gastroenterology, Post. Graduate Institute of Medical Education & Research, Chandigarh, India. **, Department of Superspeciality of Gastroenterology, Post. Graduate Institute of Medical Education & Research, Chandigarh, India. ***, Department of Superspeciality of Gastroenterology, Post. Graduate Institute of Medical Education & Research, Chandigarh, India. ****
Background: Nodular antritis is chronic inflammation presenting as multiple small nodules in the antrum. It is characterized by presence of inflammatory cells mainly monocytes and increased number of lymphoid follicles. Increased lymphoid follicles may result from chronic antigenic response to H. Pylori infection.

Aim & Objective: To study the association of H. pylori infection with nodular antritis in children with recurrent abdominal pain (RAP).

Method: A total of 136 consecutive children with RAP diagnosed by Apley's criteria were studied. All were subjected to upper gastrointestinal endoscopy 9UGIE) and antral biopsy were taken for rapid urease test (RUT) and histology. Blood was collected and serum stored at -20 degrees C for anti H.Pylori IgG ELISA stool was collected and stored as -20 degrees C for HpSA (H.pylori stool antigen) detection by ELISA (Meridian Bioscience, USA). H.pylori positivity or negativity was taken as the concordance of two of the following tests: RUT, histology and HpSA stool antigen test. H. Pylori +ve cases were given appropriate therapy for 1-2 weeks.

Results: The mean age of 136 children (M:F 84:52) in study group was 6.89+or- 2.59 years +-SD). A total of 34/136 (25%) children with RAP had nodular antritis. Out of these 32/34 (94.1%) were positive for H.pylori with any two of the three tests. Rest 102/136 (75%) children had normal or antral hyperaemia in UGIE. H.pylori was positive in 27/102 (26.47%) in non-nodular antritis cases. Thus a total of 59/136 (43.38%) children of RAP had H.pylori infection. H.pylori IgG was positive in 36/100 (36%) children while HpSA stool positive in 46/136 (33.8%) children with high specificity (96.1%).

Conclusion: 43.4% children with recurrent abdominal pain had H. pylori infection. 94.1% children of RARP with antral nodularity is associated with H. pylori infection from children of this region.
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