pylori infection in childhood causes iron deficiency (ID) or iron deficiency anemia (IDA). However, most recent studies have reported no relationship between H. pylori infection and IDA [24–27]. A number of studies suggest that age maybe an important factor in the relationship between H. pylori infection and iron deficiency with a stronger association in older age groups [28–30]. In an interesting study, Muhsen et al. [28] showed mTOR inhibitor that age may be a modifier of the relationship between H. pylori infection and anemia. When stratified

by age group, H. pylori was associated with a twofold increased prevalence of anemia in school aged children compared with infants under 18 months, independent of socioeconomic variables. However, the diagnosis of H. pylori is not straightforward in young children under 18 months of age. In this study, NU7441 concentration the difference in prevalence between the school age children

(54%) and infants (15%) needs to be evaluated, as the two age groups may be from very different populations and have very different risks of both anemia and H. pylori infection. The role of H. pylori in the development of cITP continues to evolve. A multicenter, prospective, controlled study evaluating the effect of eradication of H. pylori infection in children with cITP has been conducted in 16 Italian centers [31]. Among the large cohort of patients, those who underwent successful eradication of H. pylori infection showed a significantly higher platelet mafosfamide response. Therefore, it may be appropriate to look for H. pylori infection and eventually eradicate it in children with cITP. There is a complex interplay between all the factors that determine growth in children. In examining the relationship between H. pylori and growth, few studies have accounted for the role of other confounders such as socioeconomic

or psychosocial factors, parental height, and nutrition play in determining the final height of children. Despite new information concerning the effect of H. pylori infection on poor growth, the need for well-designed studies remains. Several studies demonstrated a relationship between H. pylori colonization and alterations in the circulating levels of growth-related molecules. Ozen et al. [32] investigated the effect of H. pylori and economic status on growth parameters leptin, ghrelin, and insulin-like growth factor (IGF)-I concentrations in children. Evidence that H. pylori may impair growth significantly was confounded by socioeconomic factors as the effect was only seen in children living in unfavorable socioeconomic conditions. There are a number of longitudinal studies that support the hypothesis that H. pylori infection might influence growth rate in children [33–35]; however, none are adequately designed to evaluate confounders of growth including other gastrointestinal infections in childhood. There is little of note in new effective treatment for H. pylori infection in children.