Severe iron-deficiency anaemia in adolescents: Consider Helicobacter pylori infection

Aim: This article describes the association of severe iron-deficiency anaemia with Helicobacter pylori gastritis. Results: We report three children who had symptomatic iron-deficiency anaemia with no obvious clinical cause and refractory to iron replacement therapy. All three underwent a diagnostic endoscopy and were found to have H. pylori gastritis. Histopathology confirmed inflammatory changes consisting of dense bands of clusters of plasma cells within the lamina propria and two of the three adolescents were noted to have numerous H. pylori in gastric crypts and glands. Two of the three cases had a urease positive test. Iron deficiency was successfully corrected following antibiotic eradication of H. pylori infection. Conclusions: This case series highlights the importance of considering H. pylori infection as a cause of refractory iron-deficiency anaemia in adolescents, even in the absence of gastrointestinal symptoms.