Pediatr Gastroenterol Hepatol Nutr.  2018 Oct;21(4):219-233. 10.5223/pghn.2018.21.4.219.

Diagnosis of Helicobacter pylori Infection in Children and Adolescents in Korea

Affiliations
  • 1Department of Pediatrics, Gyeongsang National Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea. hsyoun@gnu.ac.kr
  • 2Department of Microbiology, Gyeongsang National Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju, Korea.

Abstract

Helicobacter pylori plays an important role in the pathogenesis of chronic gastritis, peptic ulcer disease, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma. In Korea, the guidelines for the diagnosis and treatment of H. pylori infection in adults were revised in 2013. The European Helicobacter and Microbiota Study Group and Consensus panel released the fifth edition of the Maastricht Consensus Report for the management of H. pylori infection in 2015, and the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the North American Society of Paediatric Gastroenterology, Hepatology and Nutrition released the updated joint guidelines for children and adolescents in 2016. Considering these recommendations and recent progress in our research and that of other research teams, this study aimed to discuss the diagnostic strategies for H. pylori infection in children and adolescents.

Keyword

Helicobacter pylori; Diagnosis; Guideline; Child

MeSH Terms

Adolescent*
Adult
Child*
Consensus
Diagnosis*
Gastritis
Gastroenterology
Helicobacter pylori*
Helicobacter*
Humans
Joints
Korea*
Lymphoma, B-Cell, Marginal Zone
Microbiota
Peptic Ulcer
Stomach Diseases

Figure

  • Fig. 1 A comparison of the results of multiple rapid urease tests (RUTs) between 25 initial RUT-positive (A) and 25 RUT-negative (B) pediatric patients from whom five or more gastric antral biopsy specimens were also available for 13C-urea breath tests revealed that RUTs using one biopsy specimen show a maximum of 62.5% false-negative results.

  • Fig. 2 The difference in the positivity rate of rapid urease tests (RUTs) between one and three biopsy specimens obtained from the gastric antrum in the same pediatric patient according to the age groups. The positivity rate of RUTs increased with age irrespective of the number of gastric biopsy specimens. The positivity rate of RUTs with three biopsy specimens was higher than RUTs with one biopsy specimen in patients aged below 10 years of age [20]. GU1: RUT using one biopsy specimen, GU3: RUT using three biopsy specimens.

  • Fig. 3 The positivity rate and time to positivity of rapid urease tests (RUTs) in the antrum and body according to age. The positivity rate of RUTs in the antrum was higher in the age group 20 to 29 years compared with that in other three age groups, and the positivity rate of RUTs in the body decreased with increasing age (p<0.0001). The most frequent time to positivity occurred within 1 hour in the age group 20 to 29 years and within 6 to 24 hours in children (p<0.0001). The proportions of positive reactions within 1 hour were similar for the antrum and body in all groups [21].

  • Fig. 4 Seropositivity rates of the four commercial enzyme-linked immunosorbent assay kits and immunoblotting according to age. The seropositivity rates increased with age. The seropositivity rates of immunoblotting were higher than those of the ELISA kits, and the discrepancy in the seropositivity rates of anti-Helicobacter pylori immunoglobulin G (IgG) antibody was highest in the 0-to-6-month-old infants [32].


Cited by  1 articles

Changes in the Treatment Strategies for Helicobacter pylori Infection in Children and Adolescents in Korea
Jin-Su Jun, Ji-Hyun Seo, Ji-Sook Park, Kwang-Ho Rhee, Hee-Shang Youn
Pediatr Gastroenterol Hepatol Nutr. 2019;22(5):417-430.    doi: 10.5223/pghn.2019.22.5.417.


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