Original articlesHelicobacter pylori–associated iron-deficiency anemia in adolescent female athletes☆,☆☆
Section snippets
Study Population
We selected 2 coeducational schools: a general high school and a physical education high school. Blood sampling and a questionnaire survey were performed; 660 subjects who met the study requirements were enrolled. Criteria for enrollment included no history of significant diseases such as infectious or gastrointestinal bleeding disorders, and menorrhagia in girls. Of these, 440 (228 boys and 212 girls) were regular high school students and nonathletes, and 220 (148 boys and 72 girls) were
Measurement of IDA Parameters and Serum H pylori IgG Antibody
The ages of the 660 subjects ranged from 15 to 17 years (mean age, 15.9 years). The prevalence rates of anemia, IDA, and H pylori infection in athletes were higher than those of the control group (Table I).Empty Cell Number (% positive) P value Athletes (n = 220) Control group (n = 440) Anemia 32 (14.6) 42 (9.6) .05 IDA 18 (8.2) 24 (5.5) .176 H pylori infection 95 (43.2) 100 (22.7) .001 H
DISCUSSION
Our results show that pubescent female athletes are likely to have H pylori -associated IDA. Their environments, involving extended stays at training camps, overcrowding, and poor hygiene, expose them to H pylori infection. In other words, H pylori infection exacerbates the iron deficit in adolescent female athletes whose iron supply is marginal.
H pylori is acquired primarily early in life. Although there is debate as to whether residency in an institution or a nursing home beginning at an
Acknowledgements
We are indebted to the parents for allowing their sons and daughters to participate in this study, to the schoolteachers for helping us execute our study, and to Ji Sun Lee for nutritional analysis.
References (27)
Nonorthopedic problems in the aquatic athlete
Clin Sports Med
(1999)- et al.
Iron stores in professional athletes throughout the sports season
Physiol Behav
(1997) - et al.
Childhood living conditions and Helicobacter pylori seropositivity in adult life
Lancet
(1992) - et al.
Helicobacter pylori gastric infection and sideropenic refractory anemia
J Pediatr Gastroenterol Nutr
(1993) - et al.
Pervasive occult gastrointestinal bleeding in an Alaska native population with prevalent iron deficiency
JAMA
(1997) - et al.
Reversal of long-standing iron deficiency anaemia after eradication of Helicobacter pylori infection
Scand J Gastroenterol
(1997) - et al.
Unexplained refractory iron-deficiency anemia associated with Helicobacter pylori gastric infection in children: further clinical evidence
J Pediatr Gastroenterol Nutr
(1999) - et al.
Reversal of iron deficiency anemia after Helicobacter pylori eradication in patients with asymptomatic gastritis
Ann Intern Med
(1999) - et al.
Randomized placebo-controlled trial of Helicobacter pylori eradication for irondeficiency anemia in preadolescent children and adolescents
Helicobacter
(1999) - et al.
Effect of Helicobacter pylori eradication on sideropenic refractory anaemia in adolescent girls with Helicobacter pylori infection
Acta Paediatr
(2000)
Prevalence of iron deficiency in Swedish adolescents
Pediatr Res
Anemia during physical training (sports anemia)
Nutr Rev
Iron status and sports performance
Sports Med
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2020, Pediatric Gastrointestinal and Liver Disease, Sixth EditionDiagnosis of chronic anaemia in gastrointestinal disorders: A guideline by the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) and the Italian Society of Paediatric Gastroenterology Hepatology and Nutrition (SIGENP)
2019, Digestive and Liver DiseaseCitation Excerpt :Although GI diseases are well-known causes of refractory anaemia in children, the real prevalence is unclear because of the lack of systematic reviews and manuscripts investigating this specific issue. Evidence is available about the role of H. pylori, peptic diseases and IDA: a meta-analysis published in 2016 [78] has showed an important association (OR 2.2; 95% CI, 1.4–3.4) by analyzing four paediatric studies [149–152]. Following this meta-analysis, a population-based study was published [153], confirming the association between H. pylori and IDA (OR 1.7; 95% CI, 1.2–2.3).
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2014, BloodCitation Excerpt :Studies in the late 90s have established celiac disease as a possible cause of IDA refractory to oral iron treatment, without other apparent manifestations of malabsorption syndrome.10 In addition, Helicobacter pylori has been implicated in several earlier studies as a cause of IDA refractory to oral iron treatment, with a favorable response to H pylori eradication.11,12 Likewise, autoimmune atrophic gastritis, a condition associated with chronic idiopathic iron deficiency, has been shown to be responsible for refractory IDA in over 20% of patients with no evidence of gastrointestinal blood loss.13,14
The role of Helicobacter pylori infection in hematological disorders
2013, European Journal of Internal MedicineCitation Excerpt :In an initial report, a seven year-old boy with refractory unexplained IDA had resolution of the disease after treatment of the H. pylori related pangastritis [61]. Young female athletes with IDA were also investigated and it was shown that the group who received eradication treatment for H. pylori exhibited faster improvement of the anemia, while the control group treated with oral iron alone showed no significant changes regarding the course of anemia [62]. Fagan et al. examined 219 children aged 7–11 yrs with concurrent Hp-I and concluded that the resolution of the infection for > 14 months modestly reduced the prevalence of iron deficiency and substantially reduced the prevalence of iron deficiency and anemia [63].
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2018, Hematology, Transfusion and Cell TherapyThe correlation between Helicobacter pylori infection and iron deficiency anemia in women
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Supported by a grant from the Korea Research Foundation (KRF-99-003-F00181).
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Reprint requests: Yon Ho Choe, MD, Department of Pediatrics, Samsung Medical Center, 50 Ilwon-dong, Kangnam-ku, Seoul, 135-710, Korea.