Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children
Abstract Background While Helicobacter pylori (H. pylori) ulcers has declined recently, H. pylori-negative and/or gastrotoxic drug-negative peptic ulcers (HNGN-PU) has increased. This study aimed to analyze the etiology of peptic ulcers in children and the differences in clinical, laboratory, endosc...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-08-01
|
| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01416-7 |
| _version_ | 1818420224635961344 |
|---|---|
| author | Jung Yeon Joo Jin Min Cho In Hyuk Yoo Hye Ran Yang |
| author_facet | Jung Yeon Joo Jin Min Cho In Hyuk Yoo Hye Ran Yang |
| author_sort | Jung Yeon Joo |
| collection | DOAJ |
| description | Abstract Background While Helicobacter pylori (H. pylori) ulcers has declined recently, H. pylori-negative and/or gastrotoxic drug-negative peptic ulcers (HNGN-PU) has increased. This study aimed to analyze the etiology of peptic ulcers in children and the differences in clinical, laboratory, endoscopic, and histopathologic findings of peptic ulcers according to etiology, including eosinophilic gastroenteritis (EoGE). Methods In total, 255 children (157 boys and 98 girls) with peptic ulcers were recruited. The subjects were categorized into 5 groups according to the etiology of the ulcer: 1) H. pylori infection (n = 51); 2) gastrotoxic drugs (n = 18); 3) idiopathic (n = 144); 4) systemic disease (n = 23); 5) EoGE (n = 19). Clinical data were reviewed and analyzed retrospectively. Results Age at diagnosis, ulcer recurrence, atopic dermatitis history, white blood cell count, blood eosinophil count, platelet count, serum albumin level, iron level, erythrocyte sedimentation rate, and C-reactive protein level differed significantly among the 5 groups (all p < 0.05). Regarding endoscopic findings, multiple ulcers and gastric mucosal nodularity differed among the 5 groups (all p < 0.05). When comparing the EoGE ulcer group with the others, EoGE group revealed older ages (p = 0.022), higher rates of ulcer recurrence (p = 0.018), atopic dermatitis history (p = 0.001), and both blood and tissue eosinophilia (both p = 0.001). Conclusions EoGE ulcers constituted 10.2% of HNGN-PU in pediatric patients. In children with HNGN-PU, peripheral eosinophilia, ulcer recurrence, and atopic dermatitis history might imply EoGE, necessitating thorough investigation of tissue eosinophils during endoscopic biopsy. Trial registration A total of 255 children was retrospectively registered between between July 2003 and April 2017. |
| first_indexed | 2024-12-14T12:51:04Z |
| format | Article |
| id | doaj.art-50c0c1a94879489daaf1f207da583a54 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-14T12:51:04Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-50c0c1a94879489daaf1f207da583a542022-12-21T23:00:40ZengBMCBMC Gastroenterology1471-230X2020-08-012011810.1186/s12876-020-01416-7Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in childrenJung Yeon Joo0Jin Min Cho1In Hyuk Yoo2Hye Ran Yang3Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National UniversityDepartment of Pediatrics, Seoul National University Bundang Hospital, Seoul National UniversityDepartment of Pediatrics, Seoul National University Bundang Hospital, Seoul National UniversityDepartment of Pediatrics, Seoul National University Bundang Hospital, Seoul National UniversityAbstract Background While Helicobacter pylori (H. pylori) ulcers has declined recently, H. pylori-negative and/or gastrotoxic drug-negative peptic ulcers (HNGN-PU) has increased. This study aimed to analyze the etiology of peptic ulcers in children and the differences in clinical, laboratory, endoscopic, and histopathologic findings of peptic ulcers according to etiology, including eosinophilic gastroenteritis (EoGE). Methods In total, 255 children (157 boys and 98 girls) with peptic ulcers were recruited. The subjects were categorized into 5 groups according to the etiology of the ulcer: 1) H. pylori infection (n = 51); 2) gastrotoxic drugs (n = 18); 3) idiopathic (n = 144); 4) systemic disease (n = 23); 5) EoGE (n = 19). Clinical data were reviewed and analyzed retrospectively. Results Age at diagnosis, ulcer recurrence, atopic dermatitis history, white blood cell count, blood eosinophil count, platelet count, serum albumin level, iron level, erythrocyte sedimentation rate, and C-reactive protein level differed significantly among the 5 groups (all p < 0.05). Regarding endoscopic findings, multiple ulcers and gastric mucosal nodularity differed among the 5 groups (all p < 0.05). When comparing the EoGE ulcer group with the others, EoGE group revealed older ages (p = 0.022), higher rates of ulcer recurrence (p = 0.018), atopic dermatitis history (p = 0.001), and both blood and tissue eosinophilia (both p = 0.001). Conclusions EoGE ulcers constituted 10.2% of HNGN-PU in pediatric patients. In children with HNGN-PU, peripheral eosinophilia, ulcer recurrence, and atopic dermatitis history might imply EoGE, necessitating thorough investigation of tissue eosinophils during endoscopic biopsy. Trial registration A total of 255 children was retrospectively registered between between July 2003 and April 2017.http://link.springer.com/article/10.1186/s12876-020-01416-7Peptic ulcerEosinophilic gastroenteritisEosinophiliaHelicobacter pyloriNon-steroidal anti-inflammatory agentsChild |
| spellingShingle | Jung Yeon Joo Jin Min Cho In Hyuk Yoo Hye Ran Yang Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children BMC Gastroenterology Peptic ulcer Eosinophilic gastroenteritis Eosinophilia Helicobacter pylori Non-steroidal anti-inflammatory agents Child |
| title | Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children |
| title_full | Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children |
| title_fullStr | Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children |
| title_full_unstemmed | Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children |
| title_short | Eosinophilic gastroenteritis as a cause of non-Helicobacter pylori, non-gastrotoxic drug ulcers in children |
| title_sort | eosinophilic gastroenteritis as a cause of non helicobacter pylori non gastrotoxic drug ulcers in children |
| topic | Peptic ulcer Eosinophilic gastroenteritis Eosinophilia Helicobacter pylori Non-steroidal anti-inflammatory agents Child |
| url | http://link.springer.com/article/10.1186/s12876-020-01416-7 |
| work_keys_str_mv | AT jungyeonjoo eosinophilicgastroenteritisasacauseofnonhelicobacterpylorinongastrotoxicdrugulcersinchildren AT jinmincho eosinophilicgastroenteritisasacauseofnonhelicobacterpylorinongastrotoxicdrugulcersinchildren AT inhyukyoo eosinophilicgastroenteritisasacauseofnonhelicobacterpylorinongastrotoxicdrugulcersinchildren AT hyeranyang eosinophilicgastroenteritisasacauseofnonhelicobacterpylorinongastrotoxicdrugulcersinchildren |