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소아와 청소년에서 위의 장상피화생

Gastric intestinal metaplasia in children and adolescents

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Background: The incidence of intestinal metaplasia(IM) of stomach mucosa in children was reported ranging from approximately 1 to 3 percent. But, clinical implications, treatment, long-term prognosis, and surveillance protocols of this finding are not well established in this population. Study Objectives: This study aimed to evaluate the relationship between Helicobacter pylori (HP) infection and IM, and the treatment and long-term consequences of IM. Methods: During 6.5 years from March 2013 through August 2019, endoscopy with CLO test and multiple non-targeted biopsies were performed on 423 children and adolescents, 1 to 20 years of age, with alarm features associated with ulcer disease and gastritis. The clinical and laboratory records, macroscopic and microscopic findings of endoscopy were reviewed retrospectively. Results: Thirty-two cases (7.6%) of IM were identified. Two cases (6.3%) with HP infection were detected in 32 cases of IM, and 38 cases (9.7%) in 391 cases of non-IM. The Odds ratio was 0.619 (0.142-2.693). Proton pump inhibitor (PPI) was prescribed for six months in all cases of IM, and endoscopic follow-up was performed after a year in 11 cases. The disappearance of IM was detected in 6 cases (18.8%). Conclusions: The association of HP infection and IM was very low. After six months of PPI medication, the disappearance of IM was detected in a few cases. A close and prolonged clinical and endoscopic follow-up is needed for children and adolescents with IM.

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