الفهرس 
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Abstract
Helicobacter pylori is a gram-negative helical microaerophilic
flagellated bacterium found in the sterile gastric mucosa of majority of
the world’s population .It is consider an important pathogen of pediatric
gastroenterology that is acquired in early childhood.
Helicobacter pylori is a highly prevalent, serious and chronic
infection that has been associated causally with extra gastric disorders
including iron deficiency anemia.
Helicobacter pylori infection has even been implicated as a cause
of IDA refractory to oral iron treatment. Some patients with refractory
IDA have no gastrointestinal symptoms but H. pylori gastritis, as the
only cause of their anemia.
Many possible mechanisms have been proposed to explain the
relation between H. pylori gastritis and IDA including; H. pylori
infection affect the gastric body and initiate the development of atrophic
body gastritis that can in turn cause decreased gastric acid secretion
and increased intra-gastric pH . H. pylori infection adversely influences
the composition of the gastric juice; in terms of its acidity and
ascorbate content, both of which are critical for normal iron absorption.
These findings suggest that the physiological mechanisms that are
necessary for the absorption of alimentary iron in the duodenal mucosa
are impaired in patients with H.pylori gastritis, also IDA may cause
occult gastrointestinal bleeding and competition for dietary iron by the
bacteria also possible mechanism.
Aimof the work:
To detect Helicobacter pylori infection in children with iron
deficiency anemia and compare them with a control healthy group.
Patients and methods:
The present study was conducted in pediatric department of
Menoufiya University hospital, in the period from August 2015 to
September 2015.
To start this study, it is important to obtain a formed written
consent from the child’s parents and explain to them the nature and the
aim of our study.
∗This study included 2 groups:
group I (patient group): Includes 30 patients with iron
deficiency anemia. They were 18 males and 12 females ages ranged
from (2-15) years.
group II (Control group): includes 30 apparently healthy
children for comparison.
∗All children included in the study were subjected to:
Full history.
Complete clinical assessment.
Full laboratory investigations: including (CBC, serum iron,
total iron binding capacity, serum ferritin, H. pylori stool
antigen).
As regard the demographic data:
In group I and group II there were no significant statistical
difference as regard age, sex, socioeconomic standard and residence,
while there was significant difference between them as regard
consanguinity and order of birth.
As regard the anthropometric measurements:
In group I and group II, There were insignificant statistical
difference as regard weight, height and body mass index.
As regard the Complaints and physical examination of the
studied groups:
group I had increased incidence of recurrent episodes of mild
abdominal pain, reduced effort, poor concentration and loss of appetite
than group II which had most of its members with no complaints. While
in examination, group I had significant increased incidence of pallor than
group II. Both groups had normal local examination.
As regard nutritional status of the studied groups:
group I had significant increased incidence of excessive junk food
consumption, deficient dietary iron than group II which had most of its
members having balanced diet.
As Regard the laboratory data of the studied groups:
Complete blood picture in this work: showed that there is
significant lower values of CBC parameters in group I than group II.
Serum iron indices in this work: showed that there is significant
decrease in serum iron, serum ferritin, and increase in TIBC in group I
than group II.
Helicobacter pylori infection: In the present study we used H.
pylori stool Ag test to detect Helicobacter pylori infection in the
children of the study and it is found that there is increased incidence
of H. pylori infection in group I 56.7%vs 16.7%in group II.
Regarding the correlation between H. Pylori infection and
demographic data: There is no significant statistical difference
between H.pylori stool Ag positive group and H.pylori stool Ag
negative one as regard age, sex, order of birth, socioeconomic
standard. While as regard family hygiene and residence, there was
significant difference between them.
Regarding the correlation between H. Pylori infection and
anthropometric measures: There was no significant statistical
difference between both groups (positive and negative) as regard
anthropometric measures.
Regarding the correlation between H.Pylori infection and clinical
data of the studied groups: there was significant statistical
difference between the two groups (positive and negative) as regard
their complaints and incidence of pallor, while both had normal
local examination.
Regarding the correlation between H. Pylori infection and
nutritional status of the studied groups: there was significant
statistical difference between H.pylori stool Ag positive group and
H.pylori stool Ag negative group as regard their nutrition since
H.pylori stool Ag positive group members have more junk food,
imbalanced diet and less dietary iron than the negative one.
As Regard the correlation between H. Pylori stool antigen
and hematological findings of the studied groups: there was
significant decrease in Hb, HCT, MCV, MCHC values in the
positive group than the negative one while RBCS and WBCS
counts showed insignificant difference between the two groups
As Regard the correlation between H. Pylori stool antigen and
iron parameters: There is significant decrease in serum iron, serum
ferritin in H. pylori stool Ag positive children than in H. pylori
stool Ag negative children, and there is increase in TIBC level in
the positive than negative one.
As Regard diagnostic validilty of serum ferritin as a predictor of
anemia: serum ferritin had a sensitivity of 93% and specificity of
81% in prediction of anemia.