Usefulness of the serum Helicobtacer Pylori IgG Test in Children Who Visit the Emergency Department with an Unknown Cause of Gastrointestinal Symptoms

ABSTRACT

PURPOSE: Children visit the emergency department (ED) with more severe abdominal pain, nausea, and vomiting without specific cause than any other outpatients, and many have recurrent abdominal pain (RAP). For that reason, we examined the correlation between Helicobacter pylori (H. pylori) infection and these symptoms. METHODS: From August 2001 to January 2002, serum samples of H. pylori IgG were collected prospectively from 90 children under 17-years old who had visited our ED with the above symptoms. Of these, 40 children satisfying Apley 's criteria were researched. H. pylori infection was defined as a positive result on a CLO test or a C13-Urea Breath test or a modified Giemsa stain. RESULTS: The male-to-female ratio was 1.5 1, and the mean age was 8.6 +/- 3.9 years old. The mean value of the IgG level was 16.1 +/- 22.2 U/mL. Seropositive patients accounted for 11 cases (28%). Of the 30 children who had undergone upper endoscopy, 15 children were confirmed as having an H. pylori infection. The sensitivity and the specificity of H. pylori IgG were 47% and 73%. In the school-age group (>or=8 years old), the rates of IgG positivity and infection were 42% (10/24) and 70% (14/20), compared with the preschool age group value of 6% (1/16) and 10% (1/10). The most common upper endoscopy findings was nodular gastritis in 23 patients. CONCLUSION: The rate of H. pylori infection in children visiting the ED with unknown causes of above symptoms was higher than it was in a recent study. In the ED, H. pylori IgG may be required as a screening test in such children.