Usefulness of the Immunological Rapid Urease Test for Detection of Helicobacter pylori in Patients Who are Reluctant to Undergo Endoscopic Biopsies

Abstract

Cardiovascular diseases and liver cirrhosis are in the list of Helicobacter pylori-related extragastric diseases. Patients with cirrhosis and cardiovascular diseases under the control of aspirin have increased risk of gastrointestinal bleeding. The immunological rapid urease test (IRUT) provides a rapid and safe diagnostic test for H. pylori using gastric mucus collected at endoscopy. We investigated its usefulness in 93 patients with these extragastric diseases including 46 with H. pylori infection assessed by urea breath test and serology. Twenty H. pylori-infected patients received eradication therapy and the IRUT was assessed to evaluate the efficacy of bacterial eradication. The sensitivity, specificity, and positive and negative predictive values for IRUT were 96%, 90%, 90%, and 96%, respectively. The results of IRUT completely agreed with those of urea breath test following anti-H. pylori therapy. The IRUT has acceptable diagnostic performance in such cohorts reluctant to undergo endoscopic biopsies due to the risk of bleeding.

Diagnosis of Helicobacter pylori

“…A urease test based on an immunological detection of urease was proposed for the first time in Japan. Its sensitivity was 96% but its specificity only 90%[12]. Two new rapid urease tests (RUT) based on pH change were also tested.…”

Helicobacter pylori: diagnosis and treatment

“…A sensitivity of 96% and a lower specificity of 90% were lately confirmed by a Japanese group [56]. Therapeutic decisions for eradication can be based on a positive rapid urease test [3].…”