-Case Reports-

Helicobacter pylori Infection with a Duodenal Ulcer in a 6-year-old Boy

Miharu Hajikano^1,2, Yasuhiro Katsube^1,2, Yuko Takita^1,2, Takuya Okada^1,2, Makiko Asai^1,2, Mariko Fujimatsu^1,2, Yoshiki Nishizawa^1,2, Mitsuhiro Kamisago^1,2, Takehisa Fujita^1,2, Takeshi Shioya³ and Akira Tokunaga³

¹Department of Pediatrics, Nippon Medical School Graduate School of Medicine
²Department of Pediatrics, Nippon Medical School Musashikosugi Hospital
³Institute of Gastroenterology, Nippon Medical School Musashikosugi Hospital

A 6-year-old boy was hospitalized because of dark feces and facial pallor of 1 week's duration. Other gastrointestinal symptoms, including vomiting and abdominal pain, were absent, but he felt dizziness when standing and fatigue on effort. Hematologic studies revealed iron-deficiency anemia, and endoscopy showed gastric erosions and a duodenal ulcer. All test results for Helicobacter pylori infection, including H. pylori antigen in stool, anti-H. pylori IgG immunoassay in serum, and the ¹³C-urea breath test, were positive. Because an H. pylori-associated gastric ulcer had been diagnosed with endoscopy in the patient's father 3 years earlier, father-son transmission was suspected. The patient was treated with triple-agent eradication therapy (proton pump inhibitor [lansoprazol], amoxicillin, and clarithromycin) for 2 weeks. One month after therapy was completed, eradication of H. pylori was confirmed by negative results on the stool antigen test. Peptic ulcer disease can occur in young children, as in this case. The stool antigen test kit is a useful and reliable method that can be used even in preschool children to diagnose H. pylori infection.

J Nippon Med Sch 2006; 73: 292-296

Keywords
Helicobacter pylori, duodenal ulcer, dark feces, intrafamilial transmission, child

Correspondence to
Miharu Hajikano, MD, Department of Pediatrics, Nippon Medical School Musashikosugi Hospital, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
miharu@nms.ac.jp

Received, August 21, 2006
Accepted, September 22, 2006