GastroPanel: evaluation of the usefulness in the diagnosis of gastro-duodenal mucosal alterations in children.
BACKGROUND
The combined evaluation of serum pepsinogens A (PGA) and C (PGC), gastrin-17 (G17) and anti-H. pylori antibodies (anti-H. pylori)(GastroPanel) has recently been proposed as a useful aid for investigating H. pylori-associated gastric mucosal inflammation. Our aim was to evaluate whether GastroPanel can correctly classify children who need or not endoscopy (EGD).


METHODS
GastroPanel was performed in 554 consecutive children subjected to EGD.


RESULTS
PGC and anti-H. pylori were sensitive (82.5% and 73.1%) and specific (58.1% and 84.0%) indices of H. pylori infection. Antral H. pylori colonization density, inflammation and activity grades were correlated with PGC. PGC and G17 were significantly higher in children with celiac disease (14.9+/-0.88 microg/L and 5.6+/-0.79 pmol/L) than in controls (8.5+/-0.38 microg/L and 2.4+/-0.24 pmol/L). The best cut-offs to distinguish H. pylori infected children from controls were 7.45 microg/L for PGC, 4.2 pmol/L for G17, 18 U for anti-H. pylori and 25 microg/L for PGA. With these cut-offs, GastroPanel had a NPV of 89.6% and a PPV of 66.8%.


CONCLUSIONS
A negative GastroPanel result in children with upper abdominal non alarm symptoms, should allow the paediatrician to reasonably rule out the presence of major gastro-duodenal diseases and therefore avoid EGD.
Guariso
Graziella
G
Department of Pediatrics, University of Padua, Italy.
Basso
Daniela
D
Bortoluzzi
Carla-Federica
CF
Meneghel
Alessandra
A
Schiavon
Stefania
S
Fogar
Paola
P
Farina
Maria
M
Navaglia
Filippo
F
Greco
Eliana
E
Mescoli
Claudia
C
Zambon
Carlo-Federico
CF
Plebani
Mario
M
D000293:Adolescent; D000907:Antibodies, Bacterial / Q000097:blood*; D002446:Celiac Disease / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005755:Gastrins / Q000097:blood*; D005756:Gastritis / Q000175:diagnosis / Q000382:microbiology; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D020116:Pepsinogen A / Q000097:blood*; D020115:Pepsinogen C / Q000097:blood*; D012680:Sensitivity and Specificity
D000907:Antibodies, Bacterial; D005755:Gastrins; C013550:gastrin 17; D020115:Pepsinogen C; D020116:Pepsinogen A