Investigation of a possible association between refractory iron deficiency anaemia to an underlying remote helicobacter pylori infection

ABSTRACT

Helicobacter pylon is a bacterial infection accounts as the prevalent gastric pathogen. Helicobacter has been associated with many extradigestive disorders, as refractory iron deficiency anaemia [Sideropenic]. The aim of this case control study was to investigate the role of remote Helicobacter pylon infection in refractory iron deficiency anaemia [RIDA]; together with comparing two different methods for diagnosis of Helicobacter pylon infection. The study was conducted on thirty patients proved refractory IDA by therapeutic trial. Thirty normal non anaemic subjects were included as controls. Helicobacter pylon testing included stool antigen and Helicobacter pylon PCR. The Helicobacter pylon stool antigen test revealed 12 positive cases out of 30 IDA cases. Five of them were stool PCR cagA positive and four were stool PCR ureC positive. There was 100% agreement between PCR cagA and the stool antigen test in the detection of Helicobacter pylon infection [p=0.003]. Stool PCR cagA had a diagnostic accuracy of 76.67 and likelihood ratio of 3.57. There was 100% agreement between PCR ureC and the stool antigen test in the detection of Helicobacter pylon infection [p=0.009]. Stool FCR ureC had a diagnostic accuracy of 73.33 and likelihood ratio of 3.25. There was a very highly significant difference between the mean 3 of serum ferritin, serum iron, TIBC and transferrin saturation of Helicobacter pylon stool antigen positive and negative subjects [p<0.001]. Conclusion: There was a very highly significant association between Helicobacter pylon infection and refractory iron deficiency anaemia. Serum ferritin levels were significantly lower in Helicobacter pylon stool antigen positive cases than in negative cases [p< 0.001]. Helicobacter pylon positive cases were 2.7 times more likely to develop anaemia than negative cases. The Heticobacterpyioni stool antigen testing by ELISA proved to be more reliable compared to the stool PCR which is tedious and time consuming