1.Clinical characteristics analysis of peptic ulcers caused by eosinophilic gastrointestinal disorders in children
Meng JIN ; Mingran MI ; Wenwen LIU ; Kunyu YAO ; Ran ZHANG ; Xuemei ZHONG
International Journal of Pediatrics 2025;52(4):268-273
Objective:To analyze the clinical characteristics,laboratory tests,endoscopic features,treatment,and follow-up of peptic ulcers caused by eosinophilic gastrointestinal disorders(EGIDs)in children,with the aim of improving the level of understanding,diagnosis and treatment of EGIDs in children with the onset of peptic ulcers.Methods:A retrospective analysis was conducted on children admitted to the Department of Gastroenterology,Capital Center for Children's Health,Capital Medical University from January 1st,2019 to October 31st,2023,who underwent complete endoscopic examination. The first examination showed the presence of peptic ulcers(gastric or duodenal ulcers)under the endoscope,and were ultimately diagnosed with peptic ulcers caused by EGIDs through examination and follow-up. The clinical characteristics,laboratory tests,endoscopic results,and treatment follow-up were analyzed.Results:Thirty-five children were EGIDs,22 males and 13 females.Twenty-two cases(62.9%)had abdominal pain as the main symptom.Laboratory tests:17 cases(48.6%)showed a decrease in hemoglobin,15 cases(42.9%)showed an increase in eosinophil count,20 cases(57.1%)tested gastro positive for food allergen specific IgE,and 17 cases(48.6%)showed thickening of the intestinal wall on gastrointestinal ultrasound. Endoscopic features:8 cases(22.9%)showed gastric antral ulcers,including 7 cases(20.0%)with multiple gastric antral ulcers,and 25 cases(71.4%)showed duodenal bulb ulcers.There were 15 cases(42.9%)showed huge ulcers,and 14 cases(40.0%)were located in the duodenal bulb. Comparison of clinical characteristics between children with EGIDs(EGIDs group)and those with peptic ulcers caused by Helicobacter pylori infection(Hp group):the first clinical symptom in both groups was mainly abdominal pain,but the incidence rate in the EGIDs group was lower(62.9% vs 93.5%),and the weigth for length Z score in the EGIDs group was lower[0(-1.6,0.8)vs 1.1(0,1.9)],with statistical significance(all P<0.05). Comparison of laboratory tests:the EGIDs group showed a statistically significant difference in hemoglobin levels[120(101,124)g/L vs 130(100,138)g/L],eosinophil count[0.28(0.13,0.71)× 10 9/L vs 0.16(0.08,0.22)×10 9/L],a positive rate of food allergen specific IgE detection(57.1% vs 32.3%),and a positive rate of intestinal wall thickening detected by gastrointestinal ultrasound(48.6% vs 16.1%)compared with the Hp group(all P<0.05). Comparison of endoscopic examinations:multiple ulcers in the gastric antrum were more common in the EGIDs group than in the Hp group(20.0% vs 0),and the difference was statistically significant( P<0.05). Conclusion:For children with peptic ulcers with onset of abdominal pain,with anemia or malnutrition,or multiple ulcers in the gastric antrum and huge ulcers in the duodenal bulb detected by endoscopy,it is recommended to perform multi site biopsies to help diagnose EGIDs early.
2.Related factors of gastroesophageal reflux disease in children
Huijuan NING ; Xuemei ZHONG ; Yanling ZHANG ; Zheng LYU ; Kunyu YAO ; Yanfei CHEN ; Jiao WANG
Chinese Journal of General Practitioners 2023;22(6):603-607
Objective:To investigate the factors related to gastroesophageal reflux disease (GERD) in children.Methods:Clinical data of 370 children who underwent 24h multi-channel impedance-pH monitoring (24h MII-pH) in Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 2015 to December 2020 were enrolled in the study. The children were divided into GERD group ( n=202)and non-GERD group ( n=168) according to results of 24h MII-pH. The relationship of sex, age, body mass index (BMI), disease course, peripheral blood eosinophils count, IgE, Helicobacter pylori (Hp) infection, hiatus hernia of patients with GERD was analyzed by univariate and multivariate logistic regression analysis. Results:In GERD group 124 were males and 78 were females with a mean age of (6.4±4.1) years (2 months to 16.75 years), and in non-GERD group 82 were males and 86 were females with a mean age of (8.0±3.5) years (10 months to 15.17 years). Univariate logistic regression analysis showed that sex( OR=0.600,95% CI:0.396-0.908, P=0.016), age ( OR=0.537,95% CI:0.412-0.699, P<0.001)and hiatus hernia( OR=7.433,95% CI:2.567-21.520, P<0.001)were significantly associated with GERD of the children. Multivariate analysis showed that hiatus hernia ( OR=4.023,95% CI:1.298-12.470, P=0.016) was the independent risk factor, while male gender ( OR=0.567,95% CI:0.367-0.874, P=0.010) and younger age ( OR=0.613, 95%CI:0.459-0.819, P=0.001 ) were related factors of gastroesophageal reflux disease in children. Conclusion:Sex, age, and hiatal hernia are factors related to GERD in children.

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