Correlation of Serum Antibody Titres with Invasive Methods for Rapid Detection of Helicobacter Pylori Infections in Symptomatic Children
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- Category: Vol. 77, December 2009
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Correlation of Serum Antibody Titres with Invasive Methods for Rapid Detection of Helicobacter Pylori Infections in Symptomatic Children, KHALED A. IBRAHIM, SABRY M. GHANEM, ABEER M. EL-MAHALAWAY, AMER ABDELHAMEED and ALSAYED A. ABDELWAHAB
Abstract
Background: Helicobacter pylori (H pylori) are causally associated with peptic ulcer disease and gastric carcinoma. Typically children get infected during the first decade of life but diseases associated with H. pylori, are seen mainly in adults. Multiple diagnostic methods are available for the detection of Helicobacter pylori infection, but at present no single one can be used as the gold standard.
Objective (s): To evaluate the correlation and diagnostic accuracy of invasive methods {rapid urease test (RUT), Histology and bacterial culture} and non invasive one (IgG antibodies serologic test) for diagnosis of Helicobacter pylori infection in symptomatic children.
Patients and Methods: This is a prospective cohort study was done on 50 children between 2 and 18 years of age suffering from dyspeptic symptoms. Endoscopy with gastric biopsies was done for rapid urease test, culture and histopatho-logical examination, respectively. Blood sample for IgG antibodies by using commercially available enzyme-linked immunosorbent assay–(ELISA) based technology for detection of Helicobacter pylori infection.
Results: The ages of the 50 patients ranged from 3y5m to 18y [mean±SD (10.6±6.8y)], of whom 64% (32/50) were over 6 years old and 36% (18/50) under 6 years old; 64% (36/50) were male and 36% (14/50) were female. Recurrent abdominal pain was present in 96% (48/50), vomiting was present in 70% (35/50) hematemesis was in 16% (8/50) and chronic diarrhoea was in 10% (5/50). RUT and positive H pylori Ig G antibodies agreed in 88% (44/50) of patients, of which both were negative in 32% (16/50) and both were positive in 56% (28/50). Disagreement occurred in 12%: three patients (6%-3/50) presented negative H pylori IgG antibodies tests and three patients (6%-3/50) negative RUT.
Conclusion: Association of the rapid urease test with non-invasive method of serology constituted the best choice for diagnosis of Helicobacter pylori infection in symptomatic children, and bacterial culture alone could not be used as the gold standard due to its low sensitivity.