Clinical, instrumental and morphological parallels in combination of chronic gastroduodenitis and primary hypertension in children

Authors

DOI:

https://doi.org/10.14739/2310-1210.2020.3.204918

Keywords:

gastritis, duodenitis, hypertension, children, morphological study

Abstract

 

The aim: to provide clinical and instrumental characteristics and to evaluate the morphological changes of the stomach and duodenum mucous membrane in children with comorbidity of chronic gastroduodenitis (HGD) and primary hypertension (PH).

Materials and methods. 102 children aged 9–17 years with HGD and PH were examined. The first group consisted of 47 children with a combination of HGD and PН, the second group – 55 children with HGD and normal arterial pressure. Morphological study of biopsy specimens of the stomach and duodenum mucous membrane (MM) was performed in 33 children.

Results. Gastroduodenoscopy showed an erythematous gastroduodenopathy in 57.4 % of children in group І and 60.0 % of children in group ІІ (P = 0.79), hypertrophic changes in the stomach and duodenal ММ – in 6.4 % of children in group І and 12.7 % of children in group II (P = 0.28), subatrophy – in 10.6 % of children in group І and 14.5 % of children in group II (P = 0.56), erosion – in 25.5 % of children in group І and 12.7 % of children in group ІІ (P = 0.1), motor-evacuation disorders – in 63.8 % of children in group І and 41.8 % of children in group ІІ (Р = 0.03). Unlike this data, the morphological study of the MM biopsy revealed a statistically significant difference in microcirculatory disturbances in the MM, namely plethora was detected in 81.3 % of children in group I and 52.9 % of children in group II (P = 0.02), severe edema was observed in 75.0 % of children in group I and 41.2 % of children in group II (P = 0.049), hemorrhages in the lamina propria – in 62.5 % of children in group I and 23.5 % of children in group II (P = 0.02), microtrombosis – in 37.5 % of children in group I and 5.9 % of children in group II (P = 0.03), as well as concerning destructive changes in the MM: micro-erosion were found in 56.3 % of children in group I and 17.6 % of children in group II (Р = 0.02), erosion – in 43.8 % of children in group І and 11.8 % of children in group II (P = 0.04).

Conclusions. The combined course of HGD and PH in children is characterized by more frequent motor-evacuation and microcirculatory disorders (plethora, severe edema, hemorrhages in the lamina propria, microtrombosis), as well as more pronounced erosive changes in the MM as compared to an isolated course of HGD.

References

Skirda, I. Yu., Petishko, O. P., & Zavgorodnyaya, N. Yu. (2017). Epidemiolohichni osoblyvosti khvorob orhaniv travlennia v ditei ta pidlitkiv v Ukraini [Epidemiological features of diseases of the digestive system in children and adolescents in Ukraine]. Hastroenterolohiia, 51(4), 229-236. https://doi.org/10.22141/2308-2097.51.4.2017.119287 [in Ukrainian].

Bell, C. S., Samuel, J. P., & Samuels, J. A. (2019). Prevalence of Hypertension in Children. Hypertension, 73(1), 148-152. https://doi.org/10.1161/hypertensionaha.118.11673

Matukha, L. F., Orlovska, N. V., & Mayatska, O. V. (2015). Arterialna hipertenziia u ditei ta pidlitkiv: faktory ryzyku, aspekty diahnostyky ta osnovy profilaktyky [Аrterial Hypertension for children and teenagers: risk factors, diagnostic aspects and prophylaxis bases]. Simeina medytsyna, (6), 131-135. [in Ukrainian].

Marushko, Yu. V., Gischak, T. V., Zlobynets, A. S., & Myka, M. Yu. (2015). Vykorystannia levokarnitynu u kompleksnomu likuvanni ditei z poiednanoiu khronichnoiu patolohiieiu hastroduodenalnoi zony ta pervynnoiu arterialnoiu hipertenziieiu [Using Complex Treatment with Levocarnitine for Children with Combined Chronic Gastroduodenal Disease and Primary Arterial Hypertension]. Zbirnyk naukovykh prats spivrobitnykiv NMAPO im. P. L. Shupyka, (24), 313-318. [in Ukrainian].

Bogoslav, T. V., Kuznetsova, L. P., & Reshetilov, Y. I. (2017). Klinichni osoblyvosti ta stan sertsevo-sudynnoi systemy pry spoluchenomu perebihu arterialnoi hipertenzii i kyslotozalezhnykh zakhvoriuvan [Clinical features and state of the cardiovascular system in a combined course of hypertension and acid-related disease]. Ukraina. Zdorovia natsii, (2), 7-11. [in Ukrainian].

Rizzoni, D., Agabiti-Rosei, C., & Agabiti-Rosei, E. (2017). Hemodynamic Consequences of Changes in Microvascular Structure. American Journal of Hypertension, 30(10), 939-946. https://doi.org/10.1093/ajh/hpx032

Tibiriçá, E., Lorenzo, A., & Oliveira, G. M. M. (2018). Microcirculation and Cardiovascular Diseases. Arquivos Brasileiros de Cardiologia, 111(2), 120-121. https://doi.org/10.5935/abc.20180149 [in Portuguese].

Laurent, S., & Boutouyrie, P. (2015). The Structural Factor of Hypertension. Circulation Research, 116(6), 1007-1021. https://doi.org/10.1161/circresaha.116.303596

Nechitailo, Yu. N., Nechitailo, D. Yu., & Miheeva, T. N. (2018). Osoblyvosti perebihu khronichnoi hastroduodenalnoi patolohii za stanom peryferychnoi mikrotsyrkuliatsii u ditei shkilnoho viku [Peculiarities of chronic gastroduodenal pathology course by the status of peripheral microcirculation in children of school age]. Svit medytsyny ta biolohii, (3), 95-99. https://doi.org/10.26724/2079-8334-2018-3-65-95-99 [in Ukrainian].

Gutterman, D. D., Chabowski, D. S., Kadlec, A. O., Durand, M. J., Freed, J. K., Ait-Aissa, K., & Beyer, A. M. (2016). The Human Microcirculation. Circulation Research, 118(1), 157-172. https://doi.org/10.1161/circresaha.115.305364

Urbina, E. M., Lande, M. B., Hooper, S. R., & Daniels, S. R. (2018). Target Organ Abnormalities in Pediatric Hypertension. The Journal of Pediatrics, 202, 14-22. https://doi.org/10.1016/j.jpeds.2018.07.026

Hunt, R. H., Camilleri, M., Crowe, S. E., El-Omar, E. M., Fox, J. G., Kuipers, E. J., Malfertheiner, P., McColl, K. E. L., Pritchard, D. M., Rugge, M., Sonnenberg, A., Sugano, K., & Tack, J. (2015). The stomach in health and disease. Gut, 64(10), 1650-1668. https://doi.org/10.1136/gutjnl-2014-307595

Yandrapu, H., & Sarosiek, J. (2015). Protective Factors of the Gastric and Duodenal Mucosa: An Overview. Current Gastroenterology Reports, 17(6), Article 24. https://doi.org/10.1007/s11894-015-0452-2

Kvietys, P. R. (2015). Anatomy and Physiology of the Gastrointestinal Microcirculation. In P. Lanzer (Ed.), PanVascular Medicine (pp. 3501-3534). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_141

Motherwell, J., & Murfee, W. L. (2018). Modelling microvascular pathology. Nature Biomedical Engineering, 2(6), 349-350. https://doi.org/10.1038/s41551-018-0251-9

How to Cite

1.
Marushko YV, Zlobynets AS, Hychka SH, Hyshchak TV, Khomych OV, Hrynevych IV. Clinical, instrumental and morphological parallels in combination of chronic gastroduodenitis and primary hypertension in children. Zaporozhye medical journal [Internet]. 2020Jun.10 [cited 2024Apr.20];22(3). Available from: http://zmj.zsmu.edu.ua/article/view/204918

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Original research