Histopathological Findings in Duodenal Biopsy of a Mexican Children Population with Gastritis by Helicobacter Pylori

Introduction: Chronic inflammation and duodenal gastric metaplasia (DGM) increase with the presence of Helicobacter pylori (Hp). DGM is considered the earliest change in the development of duodenal ulcer in children with Hp gastritis. Until now, histopathological duodenal changes in children with Hp associated gastritis had not been studied in Mexico, where there is a high gastric Hp prevalence. Objective: This study aims to describe the histopathological findings of duodenal biopsy in a Mexican children population with Hp-associated gastritis. Materials and Methods: This cross-sectional, retrospective and analytical study examined, using light microscopy, the gastric and duodenal biopsies from a consecutive series of cases of children with and without Hp gastritis, received from 2000 to 2007. In the duodenal biopsy, active or non-active chronic duodenitis and DGM were observed. The DGM was highlighted with alcian blue/PAS stain. Results: 306 patients with a histopathological diagnosis of chronic gastritis, 95 with Hp and 211 without Hp, are included in this study. The frequency of chronic duodenitis in patients with chronic gastritis by Hp is 100%. We found the highest gastric Hp frequency (p<0.001) in the group of oldest patients (11 to 16 years). The frequency of DGM was higher (15.7% vs 7.5%) when there was gastric Hp (p<0.019). It was demonstrated that there is no correlation (p>0.05) between Hp-associated chronic gastritis and the following: alteration of villus height/crypt depth ratios, damage to surface enterocytes, loss of brush border, and duodenal ulcer. Conclusions: In the Mexican children population with and without Hp chronic gastritis studied, chronic duodenitis is a very common histopathological finding. The DGM is related to the presence and density of gastric Hp. To confirm DGM, an ancillary method could be used in the endoscopic duodenal biopsy.