The clinical relevance of Helicobacter pylori-negative chronic gastritis (HPNCG) was unknown in children. Therefore, for a study, researchers sought to determine this in patients who had esophagogastroduodenoscopy with systematic stomach sampling. Data were acquired from 1,178 consecutive children who had diagnostic esophagogastroduodenoscopy. The baseline features and long-term outcomes of children with active and inactive HPNCG and those with normal stomach histology were compared. Data on follow-up were available for up to 13 years.

In all, 24 (2.0%) children had active HPNCG, 235 (19.9%) had inactive HPNCG, 27 (2.3%) were Hpylori-positive, 46 (3.9%) had other stomach pathology, and 846 (71.8%) had normal histology. Diarrhea (31.3% vs 25.1%, P= 0.033), poor growth (23.6% vs 14.7%, P<0.001), bloody stools (13.9% vs 7.2%, P<0.001), anemia (46.5% vs 23.4%, P<0.001), hypersedimentation (39.7% vs 21.4%, P<0.001), hypoalbuminemia (40.4% vs 16.2%, P<0.001), and elevated fecal calprotectin (62.4% vs 31.5%, P<0.001) were more common and heartburn (13.9% vs 22.9%, P=0.002) less common in the HPNCG group than in the controls. During the early investigations, both active (OR 3.64, 95% CI 1.35–9.82) and inactive (2.98, 2.18–4.08) HPNCG indicated a diagnosis. Crohn’s disease (41.7%) was the most prevalent active HPNCG diagnosis, followed by celiac disease (37.3%). During the follow-up period, 7 (9.9%) of the 71 previously undiagnosed HPNCG children were diagnosed. 

HPNCG is a common discovery in children undergoing EGD, with the active form linked to Crohn’s illness and the inactive form to celiac disease. Patients with HPNCG who did not obtain an initial diagnosis had an excellent long-term prognosis.