Serum Pepsinogen l, ll Levels and Upper Gastrointestinal Diseases in Children with H. pylori Infection

ABSTRACT

PURPOSE: In H. pylori infection serum pepsinogen l/ll ratio decreases and pepsinogen ll level is increased. Increased serum pepsinogen ll level correlates with pathologic severity of gastritis. We assayed serum pepsinogen l, ll levels and pepsinogen l/ll ratio to evaluate the relationship between the serum pepsinogen level and upper gastrointestinal diseases. METHODS: One hundred and sixty-five children who had undergone upper gastrodudenal endoscopic examination with CLO test and silver stain were included. Pepsinogen l and ll levels were detected in serum by radioimmunoassay. RESULTS: Age distributions were 3 patients below 5 years, 55 patients between 6 and 10 and 107 over 11. Thirty-two (19%) were H. pylori positive, and 133 (81%) were negative. Pepsinogen l increased in H. pylori positive children (P<0.01). Pepsinogen ll were higher in the H. pylori positive patients compared to Helicobactor negative group (P<0.001). Pepsinogen l and II were significantly higher (P<0.01 in pepsinogene l P<0.01 in ll) in children with nodular gastritis with Helicobactor positive than any other disease including H. pylori negative without duodenal ulcer. Pepsinogen l/ll ratio was lower in children with nodular gastritis with H. pylori positive (P<0.001) than in children with any other disease including Helicobacter negative. CONCLUSION: These results suggest that serum pepsinogen levels are inportnat in pathogenesis of upper gastrointestinal disease in children with H. pylori infection.