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World J Gastroenterol. Feb 14, 2014; 20(6): 1379-1401
Published online Feb 14, 2014. doi: 10.3748/wjg.v20.i6.1379
Helicobacter pylori infection and extragastric disorders in children: A critical update
Lucia Pacifico, John F Osborn, Valeria Tromba, Sara Romaggioli, Stefano Bascetta, Claudio Chiesa
Lucia Pacifico, Valeria Tromba, Sara Romaggioli, Stefano Bascetta, Department of Pediatrics, Sapienza University of Rome, 324 00161 Rome, Italy
John F Osborn, Department of Health Sciences and Infectious Diseases, Sapienza University of Rome, 324 00161 Rome, Italy
Claudio Chiesa, Institute of Translational Pharmacology, National Research Council, 100 00133 Rome, Italy
Author contributions: Pacifico L, Osborn JF, Tromba V and Chiesa C designed the study, analyzed the data and wrote the manuscript; Romaggioli S and Bascetta S collected the data; all authors participated in the critical review and in the final approval of the manuscript.
Correspondence to: Claudio Chiesa, MD, Institute of Translational Pharmacology, National Research Council, Via Fosso del Cavaliere, 100 00133 Rome, Italy. claudio.chiesa@ift.cnr.it
Telephone: +39-6-49979215 Fax: +39-6-49979216
Received: September 20, 2013
Revised: November 10, 2013
Accepted: January 6, 2014
Published online: February 14, 2014
Processing time: 150 Days and 18.5 Hours
Abstract

Helicobacter pylori (H. pylori) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of extragastric disorders including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, and diabetes mellitus. The inverse relation of H. pylori prevalence and the increase in allergies, as reported from epidemiological studies, has stimulated research for elucidating potential underlying pathophysiological mechanisms. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. A further clinical challenge is whether the progressive decrease of H. pylori in the last decades, abetted by modern clinical practices, may have other health consequences.

Keywords: Helicobacter pylori; Children; Iron deficiency anemia; Chronic idiopathic thrombocytopenic purpura; Growth retardation; Asthma; Allergy; Diabetes mellitus

Core tip: It is widely accepted that Helicobacter pylori (H. pylori) infection is a key pathogen for gastroduodenal diseases. Recently, the body of literature concerning a possible association between H. pylori infection and extragastric disorders has grown rapidly. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. This review attempts to highlight the main reported associations of H. pylori with extragastric disorders in children (including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, asthma and allergic disorders, and diabetes mellitus).