Çocukluk çağında çölyak hastalığı ve Helicobacter pylori gastritinin görülme sıklığı ile aralarındaki ilişki
Öz
Giriş ve Amaç: Mikrobiyal
maruziyetin çölyak hastalık riskini etkileyebileceği, kronik gastrik
enfeksiyonların sistemik immün yanıtları etkileyerek ince bağırsakta
otoimmüniteyi tetikleyebileceği ileri sürülmektedir. Bu çalışmanın amacı merkezimizde
incelenen çocukluk çağına ait biyopsilerde çölyak hastalığı ve Helicobacter pylori gastritinin görülme
sıklığının araştırılması ve olası ilişkinin belirlenmesidir. Gereç
ve Yöntem: 01.07.2015-01.01.2018
tarihleri arasında merkezimizde incelenen ince bağırsak ve/veya mide
biyopsileri bulunan tüm çocuk hastalar çalışmaya alınmış, mide
biyopsilerinde Helicobacter pylori gastritinin,
duodenum biyopsilerinde çölyak hastalığının görülme sıklığı belirlenmiştir.
Aynı zamanda mide ve ince bağırsak biyopsileri bulunan ve çölyak hastalığı
tanısı alan olgularda, otoimmün gastrite de neden olan Helicobacter pylori’nin beraber görülme sıklığı saptanarak
aralarındaki ilişki değerlendirilmiştir. Bulgular: Mide
ve/veya duodenum biyopsisi bulunan toplam 494 olgu çalışma kapsamına alınmış ve
43 olguda sadece mide biyopsisi, 12 olguda sadece duodenum biyopsisi değerlendirilmiştir.
İncelenen 482 mide biyopsisinin 162’sinde Helicobacter
pylori (%33.6), 451 duodenum biyopsisinin 37’sinde çölyak hastalığı (%8.2) tespit
edilmiştir. Çölyak tanısı alan 33 olgudan 11’inde (%33.3) Helicobacter pylori gastriti saptanmış, çölyak tanısı bulunan 4 olgu
da mide biyopsisi bulunmadığından değerlendirilememiştir. Duodenum biyopsisi
bulunan ve Helicobacter pylori
gastriti tanısı almış 144 olgunun ise 11’inde çölyak hastalığı tespit
edilmiştir. Sonuç: Çalışmamızda normal popülasyondaki çölyak
hastalığı sıklığı ile Helicobacter pylori
gastritli olgulardaki çölyak hastalığı sıklığı benzer oranlarda saptanmıştır.
Ayrıca normal popülasyondaki Helicobacter
pylori gastriti sıklığı ile çölyak hastalarındaki Helicobacter pylori gastritinin görülme sıklığı arasında anlamlı
bir fark bulunmamıştır. Elde edilen sonuçların olası nedenleri araştırılmıştır.
Anahtar Kelimeler
Kaynakça
- 1- Green PH, Cellier C. Celiac disease. N Engl J Med 2007;357:1731-43. 2- Ertekin V, Selimoglu MA, Doneray H, Orbak Z, Ozkan B. Prevalence of celiac disease in a sample of Turkish children and adolescents with type 1 diabetes mellitus. J Clin Gastroenterol 2006;40:655-7. 3- Oberthuber G, Granditsch G, Vogelsang H. The histopathology of coeliac diease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol 1999;11:1185-94. 4- Smyk DS, Koutsoumpas AL, Mytilinaiou MG, et al. Helicobacter pylori and autoimmune disease: cause or by stander. World J Gastroenterol 2014;20:613-29. 5- Veres G, Pehlivanoglu E. Helicobacter pylori infection in pediatrics. Helicobacter 2007;12:38-44. 6- Villanacci V, Bassotti G, Liserre B, et al. Helicobacter pylori infection in patients with celiac disease. Am J Gastroenterol 2006;101:1880-5. 7- Konturek PC, Karczewska E, Dieterich W, Hahn EG, Schuppan D. Increased prevalence of Helicobacter pylori infection in patients with celiac disease. Am J Gastroenterol 2000;95:3682-3. 8- Ciacci C, Squillante A, Rendina D et al. Helicobacter pylori infection and peptic disease in coeliac disease. Eur J Gastroenterol Hepatol 2000;12:1283-7. 9- Garza-González E, Perez-Perez GI, Maldonado-Garza HJ, Bosques-Padilla FJ. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. World J Gastroenterol 2014;20:1438-49. 10- Smyk DS, Koutsoumpas AL, Mytilinaiou MG, et al. Helicobacter pylori and autoimmune disease: cause or by stander. World J Gastroenterol 2014;20:613-29. 11- Somech R, Spirer Z. Celiac disease: extraintestinal manifestations, associated diseases and complications. Adv Pediatr 2002;49:191-201. 12- Rewers M. Epidemiology of celiac disease: what are the prevalence, incidence, and progressions of celiac disease? Gastroenterology 2005;128(Suppl 1):S47-51. 13- Broide E, Sandbank J, Scapa E, et al. The immunohistochemistery profile of lymphocytic gatritis in celiac disease and helicobacter pylori infection: interplay between infection and inflammation. Mediators Inflamm 2007;2007:81838. 14- Abu Daya H, Lebwohl B, Lewis SK, Green PH. Celiac disease patients presenting with anemia have more severe disease than those presenting with diarrhe. Clin Gastroenterol Hepatol 2013;11:1472-7. 15- Dalgic B, Sari S, Basturk B, et al. Prevalence of celiac disease in healthy Turkish school children. Am J Gastroenterology 2011;106:1512-7. 16- Memeo L, Jhang j, Hibshoosh H, et al. Duodenal intraepithelial lymphocytosis with normal villous architecture: Common occurrence in Helicobacter pylori gastritis. Mod Pathol 2005;18:1134-44. 17- Crabtree JE, O’Mahony S, Wyatt JI, et al. Helicobacter pylori serology in patients with coeliac disease and dermatitis herpetiformis. J Clin Pathol 1992;45:597-600. 18- Luzza F, Mancuso M, Imeneo M, et al. Helicobacter infection in children with celiac diease: prevalence and clinicopathologic features. J Ped Gastroenterol Nutr 1999;28:143-6. 19- Diamanti A, Maino C, Niveloni S, et al. Characterization of gastric mucosal lesions in patients with Celiac disease: a prospective controlled study. Am J Gastroenterol 1999;94:1313-9. 20- Rostami-Nejad M, Villanacci V, Mashayakhi R, et al. Celiac disease and Hp infection association in Iran. Rev Esp Enferm Dig 2009;101:850-4. 21- Lasa J, Zubiaurre I, Dima G, Peralta D, Soifer L. Helicobacter pylori prevalence in patient with celiac diease: reults from a cross-sectional study. Arq Gatroenterol 2015;52:139-42. 22- Lebwohl B, Blaser MJ, Ludvigsson JF, et al. Decreased risk of celiac disease in patients with Helicobacter pylori colonization. Am J Epidemiol 2013;178:1721-30. 23- Arnold IC, Dehzad N, Reuter S, et al. Heli¬cobacter pylori infection prevents allergic asthma in mouse models through the induction of regulatory T cells. J Clin Invest 2011;121:3088-93. 24- Chen Y, Segers S, Blaser MJ. Association between Helicobacter pylori and mor¬tality in the NHANES III study. Gut 2013;62:1262-9. 25- Basyigit S, Unsal O, Uzman M, et al. Relationship between Helicobacter pylori infection and celiac disease: a crosssectional study and a brief review of the literature. Prz Gastroenterol 2017;12:49-54.
The incidence of and relationship between celiac disease and Helicobacter pylori gastritis in childhood
Öz
Background and Aims: Microbial exposure may affect
the risk of celiac disease, and chronic gastric infections may induce
autoimmunity in the small intestine by affecting systemic immune responses. The
aim of this study was to determine the prevalence of celiac
disease and Helicobacter pylori
gastritis in childhood biopsies at our center and to examine
relationship between them. Materials and Methods: All pediatric patients with small intestine
and/or gastric biopsies examined at our center between July 1, 2015 and January 1, 2018
were included in the study. The incidence of Helicobacter pylori gastritis and celiac disease was determined in gastric biopsies and duodenal
biopsies, respectively. In patients with
gastric and small intestine biopsies who were diagnosed with celiac
disease, the incidence of Helicobacter pylori
causing autoimmune gastritis was determined and the relationship between them
was evaluated. Results: A total of
494 patients with gastric and/or duodenal biopsy were included in the study, with
gastric and duodenal biopsies evaluated in 43 and 12 cases,
respectively. Helicobacter pylori
gastritis and celiac disease were detected in 162 of 482 (33.6%) gastric
biopsies and 37 of 451 (8.2%) duodenal biopsies, respectively. Helicobacter pylori gastritis was detected in 11 of 33 (33.3%)
patients with celiac
disease. Four patients with celiac disease could
not be evaluated due to unavailability of gastric biopsy. Celiac disease was detected in 11 of
144 (7.6%) patients with duodenal biopsy and a diagnosis of Helicobacter pylori gastritis. Conclusion: In our study, the frequency
of celiac disease in the normal
population and in patients with Helicobacter
pylori gastritis was found to be similar. Additionally, there was no significant
difference between the incidences of Helicobacter
pylori gastritis in the normal population versus the
patients with celiac disease. Possible reasons for these results have been investigated.
Anahtar Kelimeler
Kaynakça
- 1- Green PH, Cellier C. Celiac disease. N Engl J Med 2007;357:1731-43. 2- Ertekin V, Selimoglu MA, Doneray H, Orbak Z, Ozkan B. Prevalence of celiac disease in a sample of Turkish children and adolescents with type 1 diabetes mellitus. J Clin Gastroenterol 2006;40:655-7. 3- Oberthuber G, Granditsch G, Vogelsang H. The histopathology of coeliac diease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol 1999;11:1185-94. 4- Smyk DS, Koutsoumpas AL, Mytilinaiou MG, et al. Helicobacter pylori and autoimmune disease: cause or by stander. World J Gastroenterol 2014;20:613-29. 5- Veres G, Pehlivanoglu E. Helicobacter pylori infection in pediatrics. Helicobacter 2007;12:38-44. 6- Villanacci V, Bassotti G, Liserre B, et al. Helicobacter pylori infection in patients with celiac disease. Am J Gastroenterol 2006;101:1880-5. 7- Konturek PC, Karczewska E, Dieterich W, Hahn EG, Schuppan D. Increased prevalence of Helicobacter pylori infection in patients with celiac disease. Am J Gastroenterol 2000;95:3682-3. 8- Ciacci C, Squillante A, Rendina D et al. Helicobacter pylori infection and peptic disease in coeliac disease. Eur J Gastroenterol Hepatol 2000;12:1283-7. 9- Garza-González E, Perez-Perez GI, Maldonado-Garza HJ, Bosques-Padilla FJ. A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. World J Gastroenterol 2014;20:1438-49. 10- Smyk DS, Koutsoumpas AL, Mytilinaiou MG, et al. Helicobacter pylori and autoimmune disease: cause or by stander. World J Gastroenterol 2014;20:613-29. 11- Somech R, Spirer Z. Celiac disease: extraintestinal manifestations, associated diseases and complications. Adv Pediatr 2002;49:191-201. 12- Rewers M. Epidemiology of celiac disease: what are the prevalence, incidence, and progressions of celiac disease? Gastroenterology 2005;128(Suppl 1):S47-51. 13- Broide E, Sandbank J, Scapa E, et al. The immunohistochemistery profile of lymphocytic gatritis in celiac disease and helicobacter pylori infection: interplay between infection and inflammation. Mediators Inflamm 2007;2007:81838. 14- Abu Daya H, Lebwohl B, Lewis SK, Green PH. Celiac disease patients presenting with anemia have more severe disease than those presenting with diarrhe. Clin Gastroenterol Hepatol 2013;11:1472-7. 15- Dalgic B, Sari S, Basturk B, et al. Prevalence of celiac disease in healthy Turkish school children. Am J Gastroenterology 2011;106:1512-7. 16- Memeo L, Jhang j, Hibshoosh H, et al. Duodenal intraepithelial lymphocytosis with normal villous architecture: Common occurrence in Helicobacter pylori gastritis. Mod Pathol 2005;18:1134-44. 17- Crabtree JE, O’Mahony S, Wyatt JI, et al. Helicobacter pylori serology in patients with coeliac disease and dermatitis herpetiformis. J Clin Pathol 1992;45:597-600. 18- Luzza F, Mancuso M, Imeneo M, et al. Helicobacter infection in children with celiac diease: prevalence and clinicopathologic features. J Ped Gastroenterol Nutr 1999;28:143-6. 19- Diamanti A, Maino C, Niveloni S, et al. Characterization of gastric mucosal lesions in patients with Celiac disease: a prospective controlled study. Am J Gastroenterol 1999;94:1313-9. 20- Rostami-Nejad M, Villanacci V, Mashayakhi R, et al. Celiac disease and Hp infection association in Iran. Rev Esp Enferm Dig 2009;101:850-4. 21- Lasa J, Zubiaurre I, Dima G, Peralta D, Soifer L. Helicobacter pylori prevalence in patient with celiac diease: reults from a cross-sectional study. Arq Gatroenterol 2015;52:139-42. 22- Lebwohl B, Blaser MJ, Ludvigsson JF, et al. Decreased risk of celiac disease in patients with Helicobacter pylori colonization. Am J Epidemiol 2013;178:1721-30. 23- Arnold IC, Dehzad N, Reuter S, et al. Heli¬cobacter pylori infection prevents allergic asthma in mouse models through the induction of regulatory T cells. J Clin Invest 2011;121:3088-93. 24- Chen Y, Segers S, Blaser MJ. Association between Helicobacter pylori and mor¬tality in the NHANES III study. Gut 2013;62:1262-9. 25- Basyigit S, Unsal O, Uzman M, et al. Relationship between Helicobacter pylori infection and celiac disease: a crosssectional study and a brief review of the literature. Prz Gastroenterol 2017;12:49-54.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Nisan 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 27 Sayı: 1 |