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Tamara Sabbi, MD; Paola De Angelis, MD; Franco Colistro, MD; Luigi Dall’Oglio, MD; Giovanni Federici di Abriola, MD; Massimo Castro, MD

Arch Pediatr Adolesc Med. 2005;159:238-241.

Background  Helicobacter pylori infection is likely acquired in childhood. Helicobacter pylori is recognized as a cause of gastritis and peptic ulcer.

Objective  To investigate some noninvasive tests, particularly H pylori fecal antigen, for the diagnosis of H pylori infection in comparison with the gold-standard invasive test, esophagogastroduodenoscopy with biopsy.

Methods  We studied 250 patients (102 male; age range, 3-18 years) who underwent esophagogastroduodenoscopy with biopsy (histologic examination and rapid urease test) for a suspicious upper gastrointestinal disease; in all of them, fecal H pylori antigen, serum H pylori immunoglobulin G, and cytotoxin-associated gene product A immunoglobulin G were measured. Sensitivity and specificity of noninvasive tests were compared with those of the gold-standard esophagogastroduodenoscopy with biopsy.

Results  Ninety-three patients (37%) had positive histopathologic (Giemsa staining) and rapid urease test results. The H pylori fecal antigen revealed a sensitivity of 97%, a specificity of 98%, a positive predictive value of 97%, and a negative predictive value of 98%; serum H pylori immunoglobulin G had a sensitivity of 86%, a specificity of 80%, a positive predictive value of 72%, and a negative predictive value of 90%; and serum cytotoxin-associated gene product A immunoglobulin G had a sensitivity of 83%, a specificity of 80%, a positive predictive value of 71%, and a negative predictive value of 89%.

Conclusions  Our study demonstrates that among noninvasive and easily applicable tests, particularly in small children, H pylori fecal test is simple, suitable, and has high accuracy for the screening of H pylori–positive patients.

Author Affiliations: Pediatric Unit, "Belcolle" Hospital, Viterbo, Italy (Dr Sabbi); Digestive Surgery and Endoscopic Unit (Drs De Angelis, Dall’Oglio, and di Abriola), Central Laboratory (Dr Colistro), and Gastroenterology Unit (Dr Castro), "Bambino Gesù" Pediatric Hospital, Rome, Italy.

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