title: Diagnosis of Helicobacter pylori infection from antral biopsies in pediatric patients is urease test that reliable?
abstract: Our objectives were to determine if the urease (CLO) test alone is a reliable diagnostic test for H. pylori gastritis in children and if the density of H. pylori influences the CLO test result. We performed a combined retrospective and prospective study reviewing the results of CLO-test and histology of gastric mucosal biopsy from 67 patients (35 females) with H. pylori gastritis. Two antral biopsies were inoculated on the CLO-test and two processed for histology to grade the severity of gastritis and H. pylori density. The mean age of patients was 11 years (SD +/- 4.53). Only 50 patients tested positive for H. pylori on CLO-test, whereas all patients were positive on histology. The sensitivity of the CLO-test was 75%. There was a significant association between CLO-test positivity and the density of H. pylori organisms on histology (P < 0.01), and with the severity of gastritis (P < 0.001) by the Pearson chi-square test. However, there was no association between the density of H. pylori and severity of gastritis. In conclusion, the CLO-test is not reliable as a sole diagnostic test for H. pylori gastritis in children because of a significant number of false negatives. Histologic examination of gastric mucosal biopsy is superior to the CLO-test in diagnosing H. pylori infection.
authors.affiliation: Department of Pediatric Pathology, Children's Hospital of Michigan, Detroit, USA.
authors.forename: S
authors.initials: S
authors.lastname: Madani
authors.forename: R
authors.initials: R
authors.lastname: Rabah
authors.forename: V
authors.initials: V
authors.lastname: Tolia
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D005756:Gastritis / Q000382:microbiology / Q000503:physiopathology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000201:enzymology* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D012680:Sensitivity and Specificity; D014510:Urease / Q000032:analysis*
chemical_list: D014510:Urease