Association between <i>Helicobacter pylori</i> Infection and Iron Deficiency Anemia among School-Age Children in Sohag University Hospital, Upper Egypt

Background: Helicobacter pylori (H. pylori) infection has been suggested as a cause of iron deficiency anemia (IDA) refractory to iron therapy. Objective: The aim of this work was to evaluate the association between H. pylori infection and IDA among school-age children. Subjects and Methods: This was a prospective case-control study conducted for one year starting from March 2015 and included 200 school-age children with IDA and 50 age and sex matched non-anemic controls, attending pediatric outpatient clinic at Sohag university Hospital, Sohag, Upper Egypt. All of participants were subjected to clinical evaluation and the following investigations: CBC, serum iron, total iron binding capacity, serum ferritin and a quantitative detection of H. pylori IgG antibodies. Results: Totally, 72 (36%) children with IDA and 6 (12%) non-anemic controls had positive level for H. pylori specific IgG (P = 0.036). H. pylori IgG antibody titer showed significant positive correlation with age and significant negative correlation with each of Hb level, MCV, HCT and serum ferritin. Age was higher (p < 0.001) and hematological parameters, like Hb (p = 0.001), MCV (p = 0.002), HCT (p < 0.001) and serum ferritin (p = 0.042), were significantly lower in H. pylori positive IDA cases in comparison to H. pylori negative IDA cases. Conclusion: The results of this study demonstrate significant association between positive serology for H. pylori infection and IDA in school-age children. Moreover, infection may increase the severity of anemia.