Hostname: page-component-7c8c6479df-8mjnm Total loading time: 0 Render date: 2024-03-28T04:14:14.369Z Has data issue: false hasContentIssue false

Haematological response to iron supplementation is reduced in children with asymptomatic Helicobacter pylori infection

Published online by Cambridge University Press:  08 March 2007

Dilip Mahalanabis*
Affiliation:
Society for Applied Studies, 108 Maniktala Main Road, Flat-3/21, Kolkata – 700 054, India
M. Aminul Islam
Affiliation:
University of Alabama at Birmingham, Birmingham, Alabama, USA
Saijuddin Shaikh
Affiliation:
Society for Applied Studies, 108 Maniktala Main Road, Flat-3/21, Kolkata – 700 054, India
Monilal Chakrabarty
Affiliation:
Kothari Medical Research Centre, Kolkata, India
Anura V. Kurpad
Affiliation:
St. Johns Medical College, Bangalore, India
Swagata Mukherjee
Affiliation:
Infectious Diseases Hospital, Kolkata, India
Bandana Sen
Affiliation:
Society for Applied Studies, 108 Maniktala Main Road, Flat-3/21, Kolkata – 700 054, India
M. Abu Khaled
Affiliation:
University of Alabama at Birmingham, Birmingham, Alabama, USA
Sten H. Vermund
Affiliation:
University of Alabama at Birmingham, Birmingham, Alabama, USA
*
*Corresponding author: Dr Dilip Mahalanabis, fax +91 33 2337 6290, email dmahalanabis@vsnl.com
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

We evaluated the adverse effect of asymptomatic Helicobacter pylori infection in children on the response to Fe supplementation. One hundred and sixty-nine children aged 1–10 years from the urban poor community underwent a [13C]urea breath test for H. pylori and haematological tests at admission and after 8 weeks. Both H. pylori-positive and -negative children were randomly assigned to receive ferrous fumarate syrup (20 mg elemental Fe twice daily) or placebo for 8 weeks and a single dose of vitamin A (33,000μg). Admission findings were compared between H. pylori-positive and -negative children. Response to Fe was compared between Fe-supplemented H. pylori-positive and -negative children. Seventy-nine per cent of the children were aged 1–5 years and half of them were boys. In eighty-five H. pylori-positive and eighty-four H. pylori-negative children, the differences in mean Hb (112 (sd 12·6) v. 113 (sd 12·0) g/l), haematocrit (34 (sd 3·5) v. 35 (sd 3·2) %) and ferritin (23·8 v. 21·0 μg/l) were similar. After 8 weeks of Fe supplementation, mean Hb was 5·3 g/l more (95 % CI 1·59, 9·0) and haematocrit was 1·4 % more (95 % CI 0·2, 2·6) in H. pylori-negative (n 44) compared with H. pylori-positive (n 42) children. Mean ferritin was similar at admission and improved in both H. pylori-positive and -negative children. Asymptomatic H. pylori infection was not associated with higher rates of anaemia or Fe deficiency in children, but had a significant adverse effect on response to Fe therapy. However, this result is based on exploratory analysis and needs confirmation.

Type
Research Article
Copyright
Copyright © The Nutrition Society 2005

References

Annibale, B, Marignani, M, Monarca, B, Antonelli, G, Marcheggiano, A, Martino, G, Mandelli, F, Caprilli, RDelle Fave, G (1999) Reversal of iron deficiency anemia after Helicobacter pylori eradication in patients with asymptomatic gastritis. Ann Intern Med 131, 668672.CrossRefGoogle ScholarPubMed
Annibale, B, Capurso, G, Martino, G, Grossi, C & Delle Fave, G (2000) Iron deficiency anaemia and Helicobacter pylori infection. Int J Antimicrob Agents 16, 515519.CrossRefGoogle ScholarPubMed
Ashorn, M, Ruuska, T & Makipernaa, A (2001) Helicobacter pylori and iron deficiency anemia in children. Scand J Gastroenterol 36, 701705.CrossRefGoogle Scholar
Bardhan, PK (1997) Epidemiological features of Helicobacter pylori infection in developing countries. Clin Infect Dis 25, 973978.CrossRefGoogle ScholarPubMed
Choe, YH, Kim, SK, Son, BK, Lee, DH, Hong, YC & Pai, SH (1999) Randomized placebo-controlled trial of Helicobacter pylori eradication for iron-deficiency anemia in preadolescent children and adolescents. Helicobacter 4, 135139.CrossRefGoogle ScholarPubMed
Choe, YH, Lee, JE & Kim, SK (2000) Effect of Helicobacter pylori eradication on sideropenic refractory anemia in adolescent girls with Helicobacter pylori infection. Acta Paediatr 89, 154157.CrossRefGoogle ScholarPubMed
Choe, YH, Oh, YJ, Lee, NG, Imoto, I, Adachi, Y, Toyoda, N & Gabazza, EC (2003 a) Lactoferrin sequestration and its contribution to iron-deficiency anemia in Helicobacter pylori -infected gastric mucosa. J Gastroenterol Hepatol 18, 980985.CrossRefGoogle ScholarPubMed
Choe, YH, Kim, SK & Hong, YC (2003 b) The relationship between Helicobacter pylori infection and iron deficiency: seroprevalence study in 937 pubescent children. Arch Dis Child 88, 178.CrossRefGoogle ScholarPubMed
Crabtree, JE (1997) Inflammatory mediators in gastroenterology. Overview. Eur J Gastroenterol Hepatol 9, 10231025.CrossRefGoogle ScholarPubMed
Dibley, MJ, Goldsby, JB, Staehling, NW & Trowbridge, FL (1987) Development of normalized curves for the international growth reference: historical and technical considerations. Am J Clin Nutr 46, 736748.CrossRefGoogle ScholarPubMed
El-Omar, EM, Oien, K, El-Nujumi, A, Gillen, D, Wirz, A, Dahill, S, Williams, C, Ardill, JE & McColl, KE (1997) Helicobacter pylori infection and chronic gastric acid hyposecretion. Gastroenterology 113, 1524.CrossRefGoogle ScholarPubMed
Food and Nutrition Board, National Research Council, Recommended dietary allowances 10th edn. Washington Dc: National Academy Press, 1989.Google Scholar
Gutierrez, O, Melo, M, Segura, AM, Aangel, A, Genta, RM & Graham, DY (1997) Cure of Helicobacter pylori infection improves gastric acid secretion in patients with corpus gastritis. Scand J Gastroenterol 32, 664668.CrossRefGoogle ScholarPubMed
Hatz, RA, Rieder, G, Stolte, M, Bayerdorffer, E, Meimarakis, G, Schildberg, FW & Enders, G (1997) Pattern of adhesion molecule expression on vascular endothelium in Helicobacter pylori -associated antral gastritis. Gastroenterology 112, 19081919.CrossRefGoogle ScholarPubMed
Jurado, RL (1997) Iron, infections, and anemia of inflammation. Clin Infect Dis 25, 888895.CrossRefGoogle ScholarPubMed
Kapil, U (2003) Prevention and control of iron deficiency anemia amongst young children. Indian Pediatr 40, 293295.Google ScholarPubMed
Kirchner, T, Steininger, H & Faller, G (1997) Immunopathology of Helicobacter pylori gastritis. Digestion 58, 1416.CrossRefGoogle ScholarPubMed
Konno, M, Muraoka, S, Takahashi, M & Imai, T (2000) Iron-deficiency anemia associated with Helicobacter pylori gastritis. J Pediatr Gastroenterol Nutr 31, 5256.Google ScholarPubMed
Kostaki, M, Fessatou, S & Karpathios, T (2003) Refractory iron deficiency anaemia due to silent Helicobacter pylori gastritis in children. Eur J Paediatr 162, 177179.CrossRefGoogle ScholarPubMed
Logan, RP, Polson, RJ, Misiewicz, JJ, Rao, G, Karim, NQ, Newell, D, Johnson, P, Wadsworth, J, Walker, MM & Baron, JH (1991) Simplified single sample 13 carbon area breath test for Helicobacter pylori: comparison with histology, culture, and ELISA serology. Gut 32(12), 14611464.CrossRefGoogle Scholar
Mahalanabis, D, Rahman, MM, Sarker, SA, Bardhan, PK, Hildelrand, P, Beglinger, C & Gyr, K (1996) Helicobacter pylori infection in infants and children in a poor community of Bangladesh: prevalence, socio-economic and nutritional aspects. Int J Epidemiol 25, 894898.CrossRefGoogle Scholar
Peach, HG, Bath, NE & Farish, SJ (1998) Helicobacter pylori infection: an added stressor on iron status of women in the community. Med J Aust 169, 188190.CrossRefGoogle ScholarPubMed
Rowland, M, Lambert, I, Gormally, S, Daly, LE, Thomas, JE, Hetherington, C, Durnin, M & Drumm, B (1997) Carbon 13-labeled urea breath test for the diagnosis of Helicobacter pylori infection in children. J Pediatr 131, 815820.CrossRefGoogle ScholarPubMed
Sarker, SA, Mahalanabis, D, Hildebrand, P, Rahaman, MM, Bardhan, PK, Fuchs, G, Beglinger, C & Gyr, K (1997) Helicobacter pylori: prevalence, transmission, and serum pepsinogen II concentrations in children of a poor periurban community in Bangladesh. Clin Infect Dis 25, 990995.CrossRefGoogle ScholarPubMed
Sarker, SA, Davidsson, L, Mahmud, H, Walczyk, T, Hurrell, RF, Gyr, N & Fuchs, GJ (2004) Helicobacter pylori infection, iron, absorption, and gastric acid secretion in Bangladeshi children. Am J Clin Nutr 80, 149153.CrossRefGoogle ScholarPubMed
Sugiyama, T, Tsuchida, M, Yokota, K, Shimodan, M & Asaka, M (2002) Improvement of long-standing iron-deficiency anemia in adults after eradication of Helicobacter pylori infection. Intern Med 41, 491494.CrossRefGoogle ScholarPubMed
Vandenplas, Y, Blecker, U, Devreker, T, Keppens, E, Nijs, J, Cadranel, S, Pipeleers-Marichal, M, Goossens, A & Lauwers, S (1991) Contribution of 13 C-urea breath test for the detection of Helicobacter pylori gastritis in children. Pediatrics 90, 608610.CrossRefGoogle Scholar
Yip, R & Dallman, PR (1988) The role of inflammation and iron deficiency as causes of anemia. Am J Clin Nutr 48, 12951300.CrossRefGoogle Scholar