Usefulness of a Serological Panel Test in the Assessment of Gastritis in Symptomatic Children

Abstract

Background: Non-invasive methods are advisable for the detection of Helicobacter pylori-related chronic gastritis in pediatric patients. Serum pepsinogens I and II (sPGII and sPGII), gastrin-17 (G-17) and anti-H. pylori antibodies (IgG-Hp) have been proposed as a ‘serological gastric biopsy’. Aim: To assess H. pylori infection and to evaluate gastric mucosa status in a pediatric population by means of serological parameters such as sPGI, sPGII, G-17 and IgG-Hp. Methods: 45 consecutively children evaluated for upper gastrointestinal symptoms were analyzed. All children were submitted to upper gastrointestinal endoscopy with biopsies. Serum samples were analyzed for IgG-Hp, sPGII, sPGI and G-17 (Biohit, Helsinki, Finland). Results: 18 children had H. pylori-related mild or moderate non-atrophic chronic gastritis. They presented significantly higher mean levels of sPGII and of IgG-Hp than negative ones, eitherunder or up to 10 years. sPGI showed significantly increased levels in H. pylori-positive patients only over 10 years. G-17 levels were not different between H. pylori-positive and -negative ones. The best cut-offs of IgG-Hp, sPGII and of product IgG-Hp·sPGII, to identify H. pylori infection, were 30 IU/l, 9 µg/l, and 241 IU/l·µg/l, respectively. The product IgG-Hp·sPGII identified H. pylori infection with a 100% sensitivity, 92% specificity, 90% positive predictive value and 100% negative predictive value. IgG-Hp and IgG-Hp showed a correlation (r = 0.94; p < 0.001). Conclusions: Combined analysis of sPGII and IgG-Hp antibody levels could be recommended as a non-invasive panel for the assessment of H. pylori-related histological alterations of gastric mucosa in childhood.

Comparison of enzyme immunoassays detecting Helicobacter pylori specific IgG in serum and saliva with endoscopic and biopsy findings in patients with dyspepsia

“…[1,16] The performance of both serum and saliva immunoassays were concordant with the detection of HP in biopsies from patients with DU and approaches the fi ndings in patients with gastritis. These results are similar to previous reports, which also documented the good sensitivity and specifi city of these assays, [6,17] but a recent report from Canada demonstrated a low sensitivity and specifi city of the saliva ELISA test. [18] However, these differences can be attributed to several factors such as the type of population studied, decreased saliva fl ow due to pre-endoscopy anxiety, or differences of HP strains.…”

“…[2,3] For quick offi ce evaluation of dyspepsia and population-based studies, a simple, rapid, reliable and an inexpensive test is highly desirable. [4] Because of their reported high sensitivity and specifi city, [5,6] commercially available antibody tests seem to be well suited for epidemiological surveys, practically among children and untreated patients. [7][8][9][10] Since the pattern of HP infection in the developing world is quite distinct from that in the Western countries [11] and because the economic constraints make invasive tests diffi cult to perform, the search for reliable and cheap tests that suit such situations becomes necessary.…”

Microarray analysis of gastric mucosa among children with Helicobacter pylori infection

“…investigated serum levels of these factors in children with H. pylori infection and identified significantly elevated PGII and decreased I/II ratios. The significant elevation of PGI was confirmed in children aged >10 years old 33 . In the present study, although we observed few atrophic changes in chronically H. pylori ‐infected mucosa, most patients developed nodular gastritis as children.…”

Proteomic Characterization of Helicobacter pylori CagA Antigen Recognized by Child Serum Antibodies and Its Epitope Mapping by Peptide Array

“…In most cases, infected children are asymptomatic, but some patients develop gastritis and peptic ulcer diseases [12], [13]. Moreover, some non-gastric diseases, such as iron-deficiency anemia and epilepsy, have been suggested to be associated with H. pylori infection [14]–[16].…”