Polat, ugcin B. Şişli Etfal Eğitim ve Araştırma Hastanesi - Çocuk Kliniği, Turkey , Urgancı, Nafiye Şişli Etfal Eğitim ve Araştırma Hastanesi - Çocuk Kliniği, Turkey , Selçukcan, Feride Şişli Etfal Eğitim ve Araştırma Hastanesi - Nükleer Tıp Kliniği, TürkiyeTurkey , Yenici, Füsun N Şişli Etfal Eğitim ve Araştırma Hastanesi - Nükleer Tıp Kliniği, Turkey

EFFICACY OF NON-INVASIVE TESTS IN THE DIAGNOSIS AND POST-TREATMENT FOLLOW-UP OF HELICOBACTER PYLORI INFECTION IN PEDIATRIC PATIENTS

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Purpose: Helicobacter pylori (HP) infection is generally acquired in early childhood and is responsible for 15% of cases of peptic ulcus during their lifetime. Furthermore, recurrence of infection after successful eradication is two-fold more common in children than in adults. Therefore, widely applicable and sensitive diagnostic tests are required for children. We aimed to evaluate the C14 urea breath test (UBT) and blood serology test for the diagnosis of HP infection in children. Materials and Methods: This study included 112 children with recurrent abdominal pain, in whom positive HP results were obtained with C14 UBT and/or blood serology test. The diagnosis was confirmed histopathologically in 102 patients and they were treated. C14 UBT and/or blood serology test results were positive in 32 of the 102 patients after treatment and the diagnosis was confirmed in 21 of those 32 patients by repeated histopathological analysis. Results: The sensitivity and specificity of C14 UBT were 98.2% and 90%, and the sensitivity and specificity of HP blood serology were 87.3% and 80%, respectively. The blood serology test had a higher false-negative rate (36%) in children under seven years of age for predicting HP infection. HP treatment success was 79.5%. The C14 UBT had higher sensitivity and specificity (95.2% and 90%, respectively), whereas the blood serology had an unacceptably low specificity (64.5%) after treatment. Conclusion: False negative results are higher on evaluation of serology on diagnosis of HP infection in early childhood, and false positive results are higher during follow-up after treatment. Therefore, serology is not a reliable tool for the diagnosis and follow-up in children. C14 UBT results are compatible with histopathologic findings on diagnoses of HP, particularly for cooperative children of all ages; thus it is sufficient for diagnosis and post-treatment follow-up.

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Helicobacter Pylori , Diagnostic Tests , Children

Fırat Medical Journal

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