Çocukluk çağında çölyak hastalığı ve Helicobacter pylori gastritinin görülme sıklığı ile aralarındaki ilişki
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:
Çölyak hastalığı, Helicobacter pylori, gastrit
The incidence of and relationship between celiac disease and Helicobacter pylori gastritis in childhood
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.
Keywords:
Celiac disease, Helicobacter pylori, gastritis,
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- ISSN: 1302-5422
- Başlangıç: 2010
- Yayıncı: Türk Gastroenteroloji Vakfı
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