EVALUATION OF INVASIVE METHODS TO DIAGNOSIS Helicobacter pylori INFECTION IN CHILDREN AND ADOLESCENTS WITH DYSPEPSIA INVASIVE METHODS TO DIAGNOSE Hp INFECTION

Abstract

In our country there are few studies evaluating the accuracy of invasive methods in children, although the usual practice of endoscopic gastric biopsies to diagnose Helicobacter pylori infection. Methods: We evaluated prospectively 120 patients submitted to endoscopy for investigation of dyspeptic symptoms. Six antral biopsies were taken to detect Helicobacter pylori by rapid urease test, histology and culture. Patients were considerate infected if culture was positive or if histology and rapid urease test were positive. Results: The age ranges from 3mo to 17y (Median: 10y1mo); 54% were female and 46% were male; 44% (53/120) were infected. The endoscopic examination was normal in 54% (65/120) and abnormal in 46% (55/120). The diagnosis was gastritis - 69% (38/55), esophagitis - 13% (13/55), duodenal ulcer - 13% (7/55) and duodenitis - 5% (3/55). The 3 methods agreed in 72.5% (87/120), and were all negative in 48% (58/120) and all positive in 24.5% (29/120). The best agreement occurred between histology and rapid urease test (91.7%), followed by culture and histology (78.3%) and finally culture and rapid urease test (75%). The sensitivity of the rapid urease test was 100%, followed by histology (98.1%) and culture (56.6%). The specificity of histology was 97%, followed by rapid urease test (89.5%). Conclusions: The histology and rapid urease test combination was the most accurate to identify Helicobacter pylori infection in account of high sensitivity of rapid urease test and high specificity of histology, besides they were low cost and practicable. The culture alone must not be considered gold standard due to its low sensitivity