Eradicating H pylori in children increases serum ferritin levels

April 1, 2011

Eradicating asymptomatic Helicobacter pylori infection in children without iron deficiency does not change iron stores, according to the results of a double-blind randomized trial appearing in the March issue of the Journal of Pediatric Gastroenterology and Nutrition.

Eradicating asymptomatic Helicobacter pylori infection in children without iron deficiency does not change iron stores, according to the results of a double-blind, randomized trial published in the Journal of Pediatric Gastroenterology and Nutrition.

However, children in whom H pylori infection is cleared during follow-up have larger increases in serum ferritin levels compared with those in whom the infection persists.

Epidemiologic studies suggest that H pylori infection plays a role in iron deficiency and iron deficiency anemia. The researchers hypothesized that treating H pylori infection in children would improve levels of iron stores (serum ferritin, transferrin saturation, and mean hemoglobin) at follow-up of more than 6 months compared with children who were not treated. They thus enrolled 110 asymptomatic children 3 to 10 years old who were randomized to quadruple treatment to eradicate H pylori (lansoprazole, amoxicillin, clarithromycin, and tinidazole), iron supplementation, H pylori eradication plus iron supplementation, or placebo.

Forty-four percent of children receiving H pylori eradication treatment (with or without iron) had their infections eradicated compared with 12% of children receiving placebo. Neither intent-to-treat or per protocol analysis showed a statistically significant effect of any treatment arm on levels of markers of iron stores.

Among only the children who cleared their infection, there was a 3-fold increased change in serum ferritin levels-the marker of earliest depletion of iron stores-from baseline (+7.7 ng/mL). The analysis indicates that there is an effect of the infection on the levels of serum ferritin, according to the researchers.

The results indicate that clearing H pylori infection made a difference in the changes observed in serum ferritin, they say.

Cardenas VM, Prieto-Jimenez CA, Mulla ZD, et al. Helicobacter pylori eradication and change in markers of iron stores among non-iron-deficient children in El Paso, Texas: an etiologic intervention study. J Pediatr Gastroenterol Nutr. 2011;52(3);326-332.