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Editor,—We read with interest the study by Choe and colleagues1 in which they investigated the effect ofHelicobacter pylori infection and iron deficiency anaemia on growth, especially in pubescent children. In this study, height values were found to be below the 25th centile in 18 of 63 (28.6%) H pylori positive children. The prevalence rate of H pylori infection was 15.5% in children without iron deficiency anaemia and 31.3% in those with iron deficiency anaemia (p = 0.022). They also revealed that the mean height of subjects who had both H pylori infection and iron deficiency anaemia decreased significantly. They concluded that H pyloriinfection accompanied by iron deficiency anaemia, rather thanH pylori infection alone, might delay pubertal growth.
We investigated the frequency of diminished growth in 30H pylori positive children (21 girls and 9 boys) diagnosed by serology and histology. The mean age was 11.5 (2.0) years (range 8–15). We found 11 (36.7%) H pylori positive patients with height values below the 25th centile. Anaemia was determined in none of the patients. Mean haemoglobin concentration was 130 (8) g/l.
H pylori infection is a chronic persistent infection, leading to diminished growth. Chronic gastric inflammation, dyspepsia, decreased nutritional intake, and malnutrition could affect growth in H pylori positive patients.2 3 We did not detect anaemia in H pylori positive patients with diminished growth. We suggest that the development of short stature inH pylori positive patients may be due solely to H pylori infection itself, and is not related to iron deficiency anaemia.