Serum Pepsinogen I (PGI) and gastrin levels in children with gastritis

Background: Studies on the relationship of childhood gastritis with serum PGI and gastrin are few. This prospective study aimed to evaluate their use in the differential diagnosis and assessment of the severity of childhood gastritis. Materials and Methods: Serum PGI and gastrin G-17 (fast-postprandial) were estimated by RIA in 101 symptomatic children, aged 4-16 years (mean 102.7 y) who underwent endoscopy. PGI and gastrin were reevaluated in 14 patients after H pylori eradication. Results: A) 45 children had H pylori gastritis, B) 35 non H. pylori gastritis and C) 21 had non H. pylori normal gastric mucosa. A significant increase of PGI levels (70.9  27.1 ng/ml) was found only in group A, compared to groups B (46.412.9 ng/ml) and C (46.38 11.18 ng/ml p<0.001. There was no correlation between serum PGI levels and the severity of gastritis or the bacterial load. PGI returned to normal (p=0.02) after eradication. No difference in gastrin concentrations among the 3 groups was found. However, a positive correlation of postprandial gastrin with the severity of gastritis was noticed only in the H.pylori gastritis group (p<0.02). Serum fasting and postprandial gastrin levels were significantly reduced after H. pylori eradication (p<0.008 and p<0.03 respectively). Conclusions: Elevated serum PGI is associated with H pylori gastritis in children, while raised postprandial gastrin reflects only its severity. Key words: Children, Gastrin, Gastritis, H. pylori, Pepsinogen I