Use Caution with Serologic Testing for Helicobacter pylori Infection in Children

Khanna, Bhawna; Cutler, Alan F.; Israel, Noel R.; Perry, Marilyn; Lastovica, Albert J.; Fields, Patricia I.; Gold, Benjamin D.

doi:10.1086/515634

Cited by 139 publications

(139 citation statements)

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“…In contrast to previous studies, 5,6 we did not find an association between iron deficiency and H pylori seropositivity. Serologic testing for H pylori in children lacks sensitivity and specificity 22 and does not distinguish between past and current infection; this may have led to misclassification of H pylori status and subsequent attenuation of the association.…”

Section: Discussionmentioning

confidence: 99%

“…Serologic testing in children often leads to false-positive and -negative results and does not distinguish between past and current infection. 22 These data raise the possibility that H pylori infection may contribute to global iron deficiency, but no large or populationbased studies have been conducted to evaluate the association between iron deficiency and active H pylori infection (ie, infection documented by breath and/or stool testing) among children. …”

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confidence: 99%

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Endemic Iron Deficiency Associated With Helicobacter pylori Infection Among School-Aged Children in Alaska

et al. 2006

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OBJECTIVES. Rural Alaska Natives have a high prevalence of iron deficiency and Helicobacter pylori infection. The objective of this study was to estimate the prevalence of iron deficiency, iron-deficiency anemia, and active H pylori infection among school-aged children in rural Alaska.METHODS. We enrolled 68% (688) of the 7-to 11-year-old children from 10 predominantly Alaska Native villages in southwestern Alaska. We collected venous blood samples to assess iron deficiency and anemia. Each child was tested for active H pylori infection by 13 C-urea breath test (UBT). Evaluated risk factors included age, gender, village of residence, number of household members, number of household members who were younger than 5 years, recent antibiotic use, and household water source.RESULTS. Of 688 enrolled children, iron deficiency was present in 38%, iron-deficiency anemia was present in 7.8%, and H pylori infection by UBT was present in 86%. Iron deficiency was independently associated with living in a household with Ͼ6 people and village of residence. H pylori infection by UBT was independently associated with child's age Ն10 years and village of residence. Ninety-one percent of children with iron deficiency had H pylori infection by UBT, and children with active H pylori infection were more likely to be iron deficient than uninfected children. Children with H pylori infection by UBT were also more likely to have iron-deficiency anemia than uninfected children.CONCLUSIONS. In this study of nearly 700 children in 10 different villages in Alaska, we confirmed that the high prevalence of iron deficiency persists among schoolaged children. We found that active H pylori infection was independently associated with iron deficiency and iron-deficiency anemia among children in this region. H pylori infection may account for a portion of the iron deficiency and iron-deficiency anemia in rural Alaska and other areas with high prevalences of both conditions. Innovative approaches are critically needed to address the iron deficiency in high prevalence areas such as rural Alaska and most of the developing world. Dr Baggett assisted with study design, was the primary person responsible for study implementation during the first study year, conducted all data analysis, and was the primary manuscript author. Dr Gessner was the study primary investigator, wrote the study protocol, was the primary person responsible for study implementation during the second study year, and assisted with data analysis and preparing the manuscript. Dr Parkinson was responsible for all components of laboratory analysis, assisted with study design, and provided critical input into the final manuscript. Ms Muth assisted with study design and writing the study protocol, was the primary person responsible for administrative project management, and reviewed the final manuscript. Dr Gold contributed to the study design, data analysis, and interpretation and provided critical input into the final manuscript. 2 The prevalence of iron deficiency among children...

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Section: Discussionmentioning

confidence: 99%

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Endemic Iron Deficiency Associated With Helicobacter pylori Infection Among School-Aged Children in Alaska

et al. 2006

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“…44,45 However, these results must be evaluated carefully, considering that the age of patients can influenced serology results, 28,29 because children's holdings of antibodies can be lower than for adults. [46][47][48] These data make it difficult to standardize serology tests at pediatric ages. The results were better than reported from younger children (81% were older than 10 years).…”

Section: Discussionmentioning

confidence: 99%

“…Although the ELISA method is an easily-performed, low cost and available method, the existence of different antigens in commercial kits 44 can influence the accuracy of the method, 29 with it being possible for discord- ance between sensitivity and specificity to occur. 49,50 These data indicate that is necessary to choose a non-commercial antigen that it is specific for each country or region 48 and obtain validation of the method and the cutoff for the age and population being studied, due to differences in infection prevalence. 28,29 In summary, our result indicated that bacterial culture alone could not be used as the gold standard due to its low sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of invasive and non-invasive methods for the diagnosis of Helicobacter pylori infection in symptomatic children and adolescents

et al. 2001

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“…However, when these kits were tested in Asian countries, the diagnostic accuracy was significantly lower (Leung et al, 1999;Miwa et al, 2000;Obata et al, 2003). These differences may be due to several reasons, such as strain heterogeneity in different geographic regions (Ohtsuka et al, 1997;Miwa et al, 2002); cross-reactivity with other intestinal pathogens, which vary in different parts of the world ; and varying immunological responses to H. pylori antigens in different patient populations (Khanna et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Antigenic Proteins of Helicobacter pylori of Potential Diagnostic Value

Khalilpour

Agilan²,

Lee³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Helicobacter pylori antigen was prepared from an isolate from a patient with a duodenal ulcer. Serum samples were obtained from culture-positive H. pylori infected patients with duodenal ulcers, gastric ulcers and gastritis (n=30). As controls, three kinds of sera without detectable H. pylori IgG antibodies were used: 30 from healthy individuals without history of gastric disorders, 30 from patients who were seen in the endoscopy clinic but were H. pylori culture negative and 30 from people with other diseases. OFF-GEL electrophoresis, SDS-PAGE and Western blots of individual serum samples were used to identify protein bands with good sensitivity and specificity when probed with the above sera and HRP-conjugated anti-human IgG. Four H. pylori protein bands showed good (≥ 70%) sensitivity and high specificity (98-100%) towards anti-Helicobacter IgG antibody in culturepositive patients sera and control sera, respectively. The identities of the antigenic proteins were elucidated by mass spectrometry. The relative molecular weights and the identities of the proteins, based on MALDI TOF/ TOF, were as follows: CagI (25 kDa), urease G accessory protein (25 kDa), UreB (63 kDa) and proline/pyrroline-5-carboxylate dehydrogenase (118 KDa). These identified proteins, singly and/or in combinations, may be useful for diagnosis of H. pylori infection in patients.

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Use Caution with Serologic Testing for Helicobacter pylori Infection in Children

Cited by 139 publications

References 28 publications

Endemic Iron Deficiency Associated With Helicobacter pylori Infection Among School-Aged Children in Alaska

Endemic Iron Deficiency Associated With Helicobacter pylori Infection Among School-Aged Children in Alaska

Evaluation of invasive and non-invasive methods for the diagnosis of Helicobacter pylori infection in symptomatic children and adolescents

Antigenic Proteins of Helicobacter pylori of Potential Diagnostic Value

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