COMPARISON OF SEROLOGY, UREASE TEST AND HISTOLOGY IN THE DIAGNOSIS OF HELICOBACTER PYLORI INFECTION

61 Aim: Compare the accuracy of serology (H.pylori IgG antibody by ELISA) to endoscopic evaluation (urease test-UT, and histology) in the diagnosis of Helicobacter pylori (Hp) infection. Method: This is a retrospective chart review of patients who were evaluated for chronic abdominal pain (CAP) and of those patients who had endoscopic evaluation from March 1995- May 1998. Results: We reviewed records of 251 patients. M:F was 1:1.5, mean age is 10.19±3.7 year, range (1-18 years). 84% of the patients were evaluated for CAP. Serology for Hp was positive in 24 out of 160 patients (15%). 156 patients underwent endoscopic examination and biopsies were obtained for UT and histologic examination with special stains for Hp. Twenty three patients were diagnosed with Hp infection (14.7%). Comparing serological to endoscopic evaluation showed that 14 patients (58%) with positive serology had a negative endoscopic evaluation for Hp, and 6 patients with negative serology had Hp infection by endoscopy. The sensitivity of the serology was 57%, specificity was 90%, positive and negative predictive values were 36% and 95.6% respectively. Among the 23 patients with Hp infection diagnosed endoscopically, 21 (91%) had positive special stain for Hp and 13 (57%) had positive UT. Conclusion: Serology for Hp is a useful screening test for Hp infection in children. A positive serology should be confirmed by endoscopic evaluation. Special stain of gastric biopsies for Hp has a higher correlation with infection than a positive urease test.