jsmc-10203

ENDOSCOPIC DIAGNOSIS OF SUSPECTED H. PYLORI INFECTION IN SULAIMANI PEDIATRIC TEACHING HOSPITAL

Heersh HMH Raof Saeed a

a Department of Pediatrics, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq. 

Submitted: 5/2/2019; Accepted: 27/6/2019; Published: 21/9/2019

DOI Link: https://doi.org/10.17656/jsmc.10203 

ABSTRACT

Background 

Helicobacter pylori is a common cause for chronic gastritis, gastric atrophy, peptic ulcer disease in the pediatric age group. Infection is more common in developing countries; Transmission is fecal-oral, or oral-oral from human-to-human contact. Serology, stool antigen, urea breath test, and endoscopy are used for diagnosis.

Objectives

To evaluate endoscopic finding and biopsy results of those children who underwent upper gastrointestinal endoscopy 

Patients and Methods

We conducted this study on 49 children, all suspected of H. pylori infection, different methods were used for diagnosis serology, stool antigen and urea breath test. Every child checked by anesthesiologist before endoscopy, in all children endoscopy done after giving anesthesia, biopsy taken from every child and sent to histopathology.

Results

In our study, the sensitivity of serology was 60%, while the sensitivity of stool antigen test for H. pylori was 80% and the sensitivity of Urea breath test was 92%. Ninety percent of children with endoscopic findings of nodular gastritis were H. pylori  positive on biopsy result while 62% of children with gastritis were positive for H. pylori on biopsy result. 

Conclusions

Urea breath test is the most accurate test for diagnosis of H. pylori infection, next test is stool for H. pylori antigen while serology is not accurate for diagnosis.

KEYWORDS

 H. pylori, Urea breath test, Stool antigen, Gastritis.

References 

1. Warren JR, Marshall BJ. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet. 1983; 1:1273–5. 

2. Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1984; 1:1311.

3. Suerbaum S, Michetti P. Helicobacter pylori infection N Engl J Med. 2002 Oct 10;347(15):1175-86

   1. Cheng H, HuF, Zhang L, Yang G, Ma J, Hu J, et al. Prevalence of Helicobacter pylori infection and identification of risk factors in rural and urban Beijing, China. Helicobacter. 2009; 14:128–33. 

4.  Hatakeyama M, Higashi H. Helicobacter pylori cag A: A new paradigm for bacterial carcinogenesis. Cancer Sci. 2005;96:835–43.

5. Kuo CH, Chen YH, Goh KL, Chang LL. Helicobacter pylori and Systemic Disease. Gastroenterol Res Pract. 2014;2014:358494..

6. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006;19(3):449-90.

7. Sipponen P, Maaroos H-I. Chronic gastritis. Scand J Gastroenterol. 2015;50:657–67

8. T. Shimoyama, “Stool antigen tests for the management of Helicobacter pylori infection,” World Journal of Gastroenterology, vol. 19, no. 45, pp. 8188–8191, 2013

• 1. H. A. Metanat, S. M. Valizadeh, H. Fakheri et al., “Comparison Between 10- and 14-Day Hybrid Regimens for Helicobacter pylori Eradication: A Randomized Clinical Trial,” Helicobacter, vol. 20, no. 4, pp. 299–304, 2015

9. D. Vaira and N. Vakil, “Blood, urine, stool, breath, money, and Helicobacter pylori,” Gut, vol. 48, no. 3, pp. 287–289, 200

10. Hassan TMM, Al-Najjar SI, Al-Zahrani IH, Alanazi FIB, Alotibi MG. Helicobacter pylori chronic gastritis updated Sydney grading in relation to endoscopic findings and H. pyloriIgG antibody: diagnostic methods. J Microsc Ultrastruct. 2016;4(4):167-174.

• 1. Dixon, Michael F.; Genta, Robert; Yardley, John; Correa . Classification and Grading of Gastritis: The Updated Sydney System. The American Journal of Surgical Pathology. 20(10):1161-1181, OCT 1996.

  2.  Akeel M, Elmakki E, Shehata A, et al. Prevalence and factors for H. pyloriinfection in Saudi patients with dyspepsia. Electron Physician. 2018;10(9):7279-7286. Published 2018 Sep 9. doi:10.19082/7279

  3. Daad Akbar and Ahmed Tarif Eltahaway. Helicobacter pylori infection at a university Hospital in Saudi Arabia : prevalence, comparison of diagnostic modalities and endoscopic findings. Indian pathol. microbial 2005;48(2):181-185

  4. Babak Pourakbari, Mona Ghazi, Shima Mahmoudi . Diagnosis of Helicobacter pylori infection by invasive and noninvasive tests. Brazilian Journal of Microbiology 44, 3, 795-798 (2013) 1678-4405.

  5. Abolfazl Iranikhah, MD; Mohammad-Reza Ghadir, MD; Saeed Sarkeshikian. Stool Antigen Tests for the Detection of Helicobacter Pylori in Children. Iran J pediatr,April (2013):vol 23(no.2),138-142

  6. Shadi Kazemi, Hamid Tavakkoli, Mohamad Reza Habizadeh. Diagnostic values of Helicobacter pylori diagnostic tests: stool antigen test, urea breath test, rapid urease test, serology and histology. J Res Med Sci. 2011 Sep; 16(9): 1097–1104.

11. M Al-Fadda, J Powe, M Rezeig, M Al Nazer, AA Alrajhi, R Baynton, Comparison of Carbon-14-Urea Breath Test and Rapid Urease Test with Gastric Biopsy for Identification of Helicobacter Pylori. 2000; 20(2): 170-172

12. Omar Saadah. Helicobacter pylori infection in Saudi children; clinical, endoscopic and pathological findings. March 2010 Arab Journal of Gastroenterology 11(1):39–43

• 1.  Najafi Sani M , Kianfir H.R , Khodad A. Endoscopic nodular gastritis: an indicator of H. pyloriinection in children. Medical Journal of The Islamic Republic of Iran (MJIRI) 2005; Volume 19 (3) 195-199. 

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