The relationship between Helicobacter pylori severity and hematological parameters in pediatric patients with celiac disease

The relationship between Helicobacter pylori infection and hematological parameters in pediatric celiac disease remains controversial. While H. pylori has traditionally been associated with iron deficiency, emerging data suggest a more complex interaction. This retrospective observational study included 103 pediatric patients with biopsy-confirmed celiac disease diagnosed between 2010 and 2024. H. pylori status and severity were determined histopathologically using gastric biopsies. Hematological and biochemical parameters obtained at diagnosis were compared across H. pylori severity groups. Group comparisons were performed using Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Multinomial logistic regression analysis was conducted to evaluate factors associated with increasing H. pylori severity. Hemoglobin and hematocrit levels differed significantly across H. pylori severity groups in univariate analyses (p < 0.05). Post-hoc analyses demonstrated significantly higher hemoglobin and hematocrit levels in the 2 + H. pylori–positive group compared with the 1 + group after Bonferroni correction. In addition, significantly higher Hb level and Htc level were found in 3 + H. pylori–positive group compared with 1 + H. pylori–positive group. No significant differences were observed in ferritin or mean corpuscular volume levels. In multivariable analyses, H. pylori severity was not identified as an independent predictor of hematological parameters. In pediatric patients with newly diagnosed celiac disease, H. pylori positivity was associated with modest differences in hemoglobin and hematocrit levels in univariate analyses; however, these associations did not persist after adjustment for potential confounders. These findings suggest that H. pylori infection does not independently influence hematological status in this population. Further prospective studies incorporating direct immunological and iron metabolism markers are warranted to clarify underlying mechanisms.