PREVALENCE OF ANTIBODIES TO HELICOBACIER PYLORI (Hp) IN CHILDREN WITH RECURRENT ABDOMINAL PAIN (RAP)

Abstract

Recent studies relied on both invasive (endoscopy and biopsy) and noninvasive (serology) diagnostic procedures linve suggested that Hp is a possible cause of RAP in older children and adolescents. It has, however, been argued that serologic testing cannot yet be extondexl to younger subjects, as the age may influence immune response to Hp. We report ttie serologic findings of a prospective study in which IgG antibodies to Hp were measured by a quantitative ELISA (Helico-G, Porton Cambridge)in 45 children (mean age 7.6 years) with recurrent boats of abdominal pain for at least 3 months, as well as in 60 age-matched healthy children with no history of gastric or intestinal complaints. Serum samples were also obtained from 18 parents of children with Hp-associated RAP and 25 parents of age-matched control. A cut off 10 U/ml appeared none appropriate for screening our population, giving a sensitivity of 86.8% aid a specificity of 92.8% when tested on 41 sera obtained frcm children with known histologic Hp status. Fifteen (33.3% of RAP patients were seropositive (median, 18 U/ml), while only 4 (4.4%) of the contiol group showed high antibody titers; (median, 18.9 U/ml). Of 18 parents of seropositive children with RAP and 25 parents of seronegative healthy children, 12 (68%) and 6 (24%) had positive serologic results, respectively.Our data show with systemic immune response to Hp may also be fully established in younger children with RAP. Intrafamiliar spread of Hp may explain the high prevalence of seropositivity among these patients. A definitive answer to the clinical relevance of lip antibodies in children with RAP will require further studies.