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Association of Helicobacter pylori infection with megaloblastic anemia: a single centre experience

Nilesh Wasekar, Vinayak Wagaskar, Nalini Jadhav, Shailesh Jadhav.

Abstract
Background: Histopathological changes due to Helicobacter pylori infection are well characterized but clinical and pathological outcome resulting from the infection are incompletely described and many studies are available from western countries but few data are available from Indian population.

Objective: The study has been conducted to observe whether H. pylori infection is associated with gastric atrophy leading to the development of megaloblastic anemia.

Material and methods: It was a cross-sectional study with one year duration. Total 30 patients who were suspected to have megaloblastic anemia underwent upper endoscopy, with simultaneous test by Urease test to screen for H. pylori infection. Biopsies were taken, one from antrum and body and another from fundus. These biopsies were studied for H. pylori infection, as well as the level of gastritis and gastric atrophy. Statistical analysis was done by using percentage proportion.

Result: Out of 30 patients, 25 were male and 5 were female. Mean age of the study was 33.03±5.85 years. Age group 51–60 years had maximum i.e. 30% of patients. Out of 30 patients, 17 patients had knuckle pigmentation, 7 patients had gray hair, 2 patients had sensory ataxia and 4 patients had normal clinical findings. All the patients of the study had macrocytosis on peripheral smear. Six patients had thrombocytopenia and 5 patients had hypersegmented neutrophils. Out of 30 patients, 10, 2, and 4 patients had mild, moderate, and severe gastritis, respectively on histopathological examination. Five patients had chronic gastritis and 3 had superficial gastritis. Four patients had normal biopsy and 2 patients had pure atrophy. Only one patient came positive for H. pylorus and rest 29 patients were negative for H. pylori.

Conclusion: Incidence of H. pylori in the study population of 30 megaloblastic patients was found to be 3%. H. pylori are not associated with gastric atrophy.

Key words: Atrophy, gastritis, gastric mucosa, Helicobacter pylori infection


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