Some studies suggested an association between Helicobacter pylori infection and iron-deficiency anemia, however, the link between weight loss and the infection in childhood remains non-established. In a retrospective cohort study, we compared H. pylori positivity rates of Bulgarian children without or with anemia (47 children in each group) or weight loss (45 children in each group) and both conditions (17 children in each group). H. pylori infection was associated with the presence of anemia (in 76.6% of the anemic vs. 21.3% of the non-anemic patients, P < 0.0001) and weight loss (in 82.2% of the patients vs. 17.8% of the control children, P < 0.0001). All 17 patients with both conditions were H. pylori positive. Relative risk of anemia, weight loss and both conditions was 3.6 (95% CI, 2.0–6.4), 4.6 (95% CI, 2.4–8.8) and 5.7 (95% CI, 2.0–15.8), respectively, in the children with H. pylori infection. In conclusion, H. pylori infection was significantly associated with iron-deficiency anemia or/and weight loss in Bulgarian pediatric patients. Therefore, diagnostics and treatment of the infection as well as a proper control of the eradication success can be beneficial and thus, can be recommended for children with those conditions.
Bruel H, Dabadie A, Pouedras P, Gambert C, Le Gall E, Jezequel C. Anémie aiguë révélatrice d'une gastrite à Helicobacter pylori [Helicobacter pylori gastritis manifested by acute anemia]. Ann Pediatr (Paris) 1993; 40(6): 364–7.
Yokota S, Toita N, Yamamoto S, Fujii N, Konno M. Positive relationship between a polymorphism in Helicobacter pylori neutrophil-activating protein a gene and iron-deficiency anemia. Helicobacter 2013; 18(2): 112–16.
Hudak L, Jaraisy A, Haj S, Muhsen K. An updated systematic review and meta-analysis on the association between Helicobacter pylori infection and iron deficiency anemia. Helicobacter 2017; 22: 1.
Kato S, Osaki T, Kamiya S, Zhang XS, Blaser MJ. Helicobacter pylori sabA gene is associated with iron deficiency anemia in childhood and adolescence. PLoS One 2017; 12(8): e0184046.
Duclaux-Loras R, Lachaux A. Anémie ferriprive de l'adolescent liée à une infection à Helicobacter pylori, à propos d'un cas [Helicobacter pylori infection, a classic but often unrecognized cause of iron deficiency anemia in teenagers]. Arch Pediatr 2013; 20(4): 395–7.
Hacibekiroglu T, Basturk A, Akinci S, Bakanay SM, Ulas T, Guney T, . Evaluation of serum levels of zinc, copper, and Helicobacter pylori IgG and IgA in iron deficiency anemia cases. Eur Rev Med Pharmacol Sci 2015; 19(24): 4835–40.
Gheibi SH, Farrokh-Eslamlou HR, Noroozi M, Pakniyat A. Refractory iron deficiency anemia and Helicobacter pylori infection in pediatrics: a review. Iran J Ped Hematol Oncol 2015; 5(1): 50–64.
Wenzhen Y, Yumin L, Kehu Y, Bin M, Quanlin G, Donghai W, . Iron deficiency anemia in Helicobacter pylori infection: meta-analysis of randomized controlled trials. Scand J Gastroenterol 2010; 45(6): 665–76.
John S, Baltodano JD, Mehta N, Mark K, Murthy U. Unexplained iron deficiency anemia: does Helicobacter pylori have a role to play? Gastroenterol Rep (Oxf) 2018; 6(3): 215–20.
Malfertheiner P, Megraud F, O'Morain CA, Gisbert JP, Kuipers EJ, Axon AT. Management of Helicobacter pylori infection-the Maastricht V/Florence consensus report. Gut 2017; 66(1): 6–30.
Choi JS, Ko KO, Lim JW, Cheon EJ, Lee GM, Yoon JM. The association between Helicobacter pylori infection and body weight among children. Pediatr Gastroenterol Hepatol Nutr 2016; 19(2): 110–15.
Boyanova L, Hadzhiyski P, Markovska R, Yaneva P, Yordanov D, Gergova G, . Prevalence of Helicobacter pylori is still high among symptomatic Bulgarian children. Acta Microbiol Immunol Hung 2019; 66(2): 255–60.
Boyanova L, Gergova G, Nikolov R, Davidkov L, Kamburov V, Jelev C, . Prevalence and evolution of Helicobacter pylori resistance to 6 antibacterial agents over 12 years and correlation between susceptibility testing methods. Diagn Microbiol Infect Dis 2008; 60(4): 409–15.
Windle HJ, Kelleher D, Crabtree JE. Childhood Helicobacter pylori infection and growth impairment in developing countries: a vicious cycle? Pediatrics 2007; 119(3): e754–9.
Boyanova L. Role of Helicobacter pylori virulence factors for iron acquisition from gastric epithelial cells of the host and impact on bacterial colonization. Future Microbiol 2011; 6(8): 843–6.
Boyanova L, Markovska R, Yordanov D, Marina M, Ivanova K, Panayotov S, . High prevalence of virulent Helicobacter pylori strains in symptomatic Bulgarian patients. Diagn Microbiol Infect Dis 2009; 64(4): 374–80.
Raj P, Thompson JF, Pan DH. Helicobacter pylori serology testing is a useful diagnostic screening tool for symptomatic inner city children. Acta Paediatr 2017; 106(3): 470–7.
Shu X, Ping M, Yin G, Jiang M. Investigation of Helicobacter pylori infection among symptomatic children in Hangzhou from 2007 to 2014: a retrospective study with 12,796 cases. Peer J 2017; 5: e2937.
Franceschi F, Annalisa T, Teresa DR, Giovanna D, Ianiro G, Franco S, . Role of Helicobacter pylori infection on nutrition and metabolism. World J Gastroenterol 2014; 20(36): 12809–17.
Romo-González C, Mendoza E, Mera RM, Coria-Jiménez R, Chico-Aldama P, Gomez-Diaz R, . Helicobacter pylori infection and serum leptin, obestatin, and ghrelin levels in Mexican schoolchildren. Pediatr Res 2017; 82(4): 607–13.
Talley NJ, Stanghellini V, Heading RC, Koch KL, Malagelada JR, Tytgat GN. Functional gastroduodenal disorders. Gut 1999; 45(Suppl. 2): II37–42.