ABSTRACT
OBJECTIVE: The aim of this study was to investigate the usefulness of five diagnostic tests for Helicobacter pylori (Hp) infection in children. PATIENTS AND METHODS: Sixty-five children with epigastric pain, recurrent abdominal pain, regurgitation, diarrhoea, anemia and insulin-dependent diabetes mellitus were investigated. Endoscopic biopsies from gastric antrum were performed and examined by the urease rapid test, histological examination and microbiological culture. An ELISA was used to detect specific IgG and anti-Hp. A carbon urea breath test was performed in 58 patients. RESULTS: Fifty-three patients were infected with Hp. The endoscopy appearance revealed nodularity in antral mucosa in 42 (79%) and erosions in 1 patient. The histology showed gastritis in all patients infected and Hp was identified in 46. The urease rapid test was positive in 96% and the culture positive in 89% of the patients infected. IgG antibodies to Hp were detected in 67% of the patients infected and the carbon urea breath test was positive in 96%. Twelve children were Hp negative, two of them having gastritis without Hp by histology. In the urease rapid test 3 false-positive results were detected and 1 false positive was found in the cultures. All Hp negative patients had negative results in the carbon urea breath test and were negative for IgG antibodies to Hp. CONCLUSIONS: The carbon urea breath test has a high sensitivity and specificity for the diagnosis of Hp infection and allows the selection of candidates for endoscopy.
Subject(s)
Helicobacter Infections/diagnosis , Helicobacter pylori , Adolescent , Antibodies, Bacterial/blood , Biopsy , Breath Tests/methods , Child , Child, Preschool , Female , Gastric Mucosa/microbiology , Gastric Mucosa/pathology , Gastroscopy , Helicobacter pylori/enzymology , Helicobacter pylori/immunology , Helicobacter pylori/isolation & purification , Humans , Male , Sensitivity and Specificity , Urease/analysisABSTRACT
Between 1980 and 1990, we have diagnosed fourteen cases of cholelithiasis in children at our hospital. Abdominal pain was the most common symptom. Diagnosis was made by abdominal ultrasonography in all of the cases. Risk factors were found in 4 children. Family history was present in four patients. The treatments performed included cholecystectomy in five cases, extracorporeal lithotripsy in one case and a dietary regimen with regular clinical reviews in eight patients.
