Table of Contents Author Guidelines Submit a Manuscript
Canadian Journal of Gastroenterology
Volume 19, Issue 7, Pages 421-424
Helicobacter Pylori Consensus Update 2004

Extradigestive Manifestation of Helicobacter Pylori Infection in Children and Adolescents

Philip M Sherman and Frank YH Lin

Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

Copyright © 2005 Canadian Association of Gastroenterology. This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (, which permits reuse, distribution, and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes.


Helicobacter pylori infection fulfills each of Koch's postulates as a human pathogen causing chronic active gastritis. Disease consequences that develop in a subset of infected subjects include peptic ulcerations, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma. More recently, multiple publications have advocated a role for H pylori infection in causing a variety of extraintestinal manifestations. Many of these reports suffer from being case reports or case series without adequate controls. As a result, purported manifestations may simply be coincidental in nature. On the other hand, increasing evidence supports H pylori infection as a cause of sideropenic (refractory iron deficiency) anemia. Moderate evidence supports H pylori gastric infection as a cause of some cases of immune thrombocytopenic purpura due to molecular mimicry. Guidelines should be adjusted in accordance with advancing knowledge in the field.