@article {Harris343, author = {Paul R Harris and Carolina A Serrano and Andrea Villagr{\'a}n and Marjorie M Walker and Melanie Thomson and Ignacio Duarte and Henry J Windle and Jean E Crabtree}, title = {Helicobacter pylori-associated hypochlorhydria in children, and development of iron deficiency}, volume = {66}, number = {4}, pages = {343--347}, year = {2013}, doi = {10.1136/jclinpath-2012-201243}, publisher = {BMJ Publishing Group}, abstract = {Aims Acute Helicobacter pylori infection is associated with transient hypochlorhydria. In H pylori-associated atrophy, hypochlorhydria has a role in iron deficiency (ID) through changes in the physiology of iron-complex absorption. The aims were to evaluate the association between H pylori-associated hypochlorhydria and ID in children. Methods Symptomatic children (n=123) were prospectively enrolled. Blood, gastric juice and gastric biopsies were taken, respectively, for haematological analyses, pH assessment and H pylori determination, and duodenal biopsies for exclusion of coeliac disease. Stool samples were collected for parasitology/microbiology. Thirteen children were excluded following parasitology and duodenal histopathology, and five due to impaired blood analysis. Results Ten children were hypochlorhydric (pH\>4) and 33 were H pylori positive. In H pylori-positive children with pH\>4 (n=6) serum iron and transferrin saturation levels \% were significantly lower (p\<0.01) than H pylori-positive children with pH<=4. No differences in ferritin, or total iron binding capacity, were observed. In H pylori-negative children with pH\>4, iron and transferrin saturation were not significantly different from children with pH<=4. Conclusions Low serum iron and transferrin in childhood H pylori infection is associated with hypochlorhydria. In uninfected children, hypochlorhydria was not associated with altered serum iron parameters, indicating a combination of H pylori infection and/or inflammation, and hypochlorhydria has a role in the aetiology of ID. Although H pylori-associated hypochlorhydria is transient during acute gastritis, this alters iron homeostasis with clinical impact in developing countries with a high H pylori prevalence.}, issn = {0021-9746}, URL = {https://jcp.bmj.com/content/66/4/343}, eprint = {https://jcp.bmj.com/content/66/4/343.full.pdf}, journal = {Journal of Clinical Pathology} }