Praediktiver Wert einer Latex-Agglutination auf Helicobacter pylori bei Kindern mit rezidivierenden abdominellen Beschwerden

Ploier, Robert; Rezanka, E; Emhofer, Josef; Dorninger, L.; Feichtinger, J.; Haidinger, Renate; Schwarzlmüller, B

doi:10.1055/s-2008-1046500

Cited by 3 publications

(1 citation statement)

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“…This value decreases to 9% in children aged 1 to 2 years, and reaches 35% in subjects aged 15 to 20 years (20). However, some investigators have sought to determine the role of HP infection in symptomatic children; the results of some studies are shown in Table 2 (8,12,21‐23). Although these series differ in clinical criteria for enrollment, we found the value of HP prevalence in children with dyspepsia reflects that described in series of equivalent size from countries with a similar social and economic development.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Rutigliano,

Ierardi,

Francavilla

et al. 1999

J. pediatr. gastroenterol. nutr.

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Background:This is a report of the results of a multicenter study performed in children with dyspepsia from five pediatric centers in Puglia, a region in southern Italy. In the study, clinical features of Helicobacter pylori infection, the reliability of diagnostic techniques, and the involvement of bacterial strains were examined.Methods:Fifty‐three outpatients with dyspepsia enrolled in our study and compiled a diary recording clinical symptoms in patients before they underwent the following diagnostic techniques: endoscopy, biopsy for histologic analysis, rapid urease test, 13C urea breath test, serology specific for immunoglobulin (Ig) G and anti‐CagA and VacA.Results:H. pylori showed a prevalence of 30.2% (n = 16). Histologic positivity was seen in all patients at the antral level (H. pylori‐associated chronic gastritis). In the gastric body, bacterial chronic active gastritis was present only in six patients (H. pylori‐associated chronic pangastritis). Clinical evaluation showed a significant difference in favor of subjects positive for H. pylori only for epigastric burning and/or pain (p < 0.001). The comparison of results of diagnostic tests, using histology as the gold standard, showed sensitivity and specificity of more than 93% for 13C urea breath test and more than 85% for rapid urease test and serology. Anti‐CagA antibodies were found in 64.3% and anti‐VacA antibodies in 42.8% of H. pylori‐positive patients.Conclusions:H. pylori prevalence in children with dyspepsia from the geographic area studied in comparable with that found in other developed countries. Approximately 50% of the studied patients were infected by cytotoxic strains. The urea breath test was the most reliable noninvasive diagnostic tool and is suitable for routine use, although endoscopy with histologic assessment remains the definitive investigation and is particularly important in patients with positive serology for CagA and VacA. Finally, the frequency of aggressive strains in our region seems to affect the clinical pattern; this emphasizes the importance of definitive diagnosis in children and offers a new role for serology.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Rutigliano,

Ierardi,

Francavilla

et al. 1999

J. pediatr. gastroenterol. nutr.

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Non-invasive diagnostic tests forHelicobacter pyloriinfection

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Takwoingi

Siddique

et al. 2018

Cochrane Database of Systematic Reviews

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130

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In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions.

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Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Rutigliano¹,

Ierardi²,

Francavilla³

et al. 1999

Journal of Pediatric Gastroenterology & Nutrition

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H. pylori prevalence in children with dyspepsia from the geographic area studied is comparable with that found in other developed countries. Approximately 50% of the studied patients were infected by cytotoxic strains. The urea breath test was the most reliable noninvasive diagnostic tool and is suitable for routine use, although endoscopy with histologic assessment remains the definitive investigation and is particularly important in patients with positive serology for CagA and VacA. Finally, the frequency of aggressive strains in our region seems to affect the clinical pattern; this emphasizes the importance of definitive diagnosis in children and offers a new role for serology.

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Praediktiver Wert einer Latex-Agglutination auf Helicobacter pylori bei Kindern mit rezidivierenden abdominellen Beschwerden

Cited by 3 publications

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Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

Non-invasive diagnostic tests forHelicobacter pyloriinfection

Helicobacter pylori and Nonulcer Dyspepsia in Childhood: Clinical Pattern, Diagnostic Techniques, and Bacterial Strains

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