Pylori Antibodies Research Articles

Diagnostic Accuracy of the E-Plate Serum Antibody Test Kit in Detecting Helicobacter pylori Infection Among Japanese Children

BackgroundA number of noninvasive diagnostic tests are available to detect Helicobacter pylori infection. Data on serologic testing of children are lacking, however, and thus it remains unclear whether the serology cutoff points used for adults are appropriate for children.MethodsSerum and stool samples were obtained from 73 children who visited 5 hospitals in Japan between March 1993 and December 2009. Analysis of stool samples was carried out using an H pylori stool antigen enzyme-linked immunosorbent assay (HpSA ELISA), and serum antibodies to H pylori were examined using an antibody determination kit (E-Plate Eiken H pylori antibody). The validity of the serologic test was evaluated based on its sensitivity, specificity, and receiver operating characteristics curve.ResultsOf the 73 children included in this study, 34 were HpSA-positive and 39 were negative. Among the 34 HpSA-positive patients, 32 were IgG-positive and 2 were IgG-negative. Of the 39 patients who were HpSA-negative, 38 were IgG-negative and 1 was IgG-positive. The sensitivity, specificity, and positive likelihood ratio for IgG antibody testing were 91.2%, 97.4%, and 35.6, respectively, based on the recommended adult cutoff point of 10 U/ml. Among children, use of cutoff points in the range of 7 to 9 U/ml yielded optimal values for sensitivity and specificity, as well as a positive likelihood ratio.ConclusionsThe performance of the E-plate anti-H pylori IgG antibody test was comparable to that of the stool antigen test and is therefore suitable for epidemiologic studies of H pylori infection in large samples.

Helicobacter heilmanniisensu stricto-related gastric ulcers: A case report

A spiral bacterium (SH9), morphologically different from Helicobacter pylori (H. pylori), was found in a 62-year-old woman's gastric mucosa. Gastroscopic examination revealed multiple gastric ulcers near the pyloric ring; mapping gastric biopsy showed mild mononuclear infiltration with large lymphoid follicles in the antrum, without corpus atrophy. Urea breath test and H. pylori culture were negative, but Giemsa staining of biopsies revealed tightly coiled bacteria that immunostained with anti-H. pylori antibody. Sequencing of SH9 16S rRNA and the partial urease A and B subunit genes showed that the former sequence had highest similarity (99%; 1302/1315 bp) to Helicobacter heilmannii (H. heilmannii) sensu stricto (H. heilmannii s.s.) BC1 obtained from a bobcat, while the latter sequence confirmed highest similarity (98.3%; 1467/1493 bp) to H. heilmannii s.s. HU2 obtained from a human. The patient was diagnosed with multiple gastric ulcers associated with H. heilmannii s.s. infection. After triple therapy (amoxicillin, clarithromycin, and lansoprazole) with regimen for eradicating H. pylori, gastroscopy showed ulcer improvement and no H. heilmannii s.s. upon biopsy.

Can Helicobacter pylori infection influence human reproduction?

Helicobacter pylori (H. pylori) infection could be associated with extra-digestive diseases. Here, we report the evidences concerning the decrease in reproductive potential occurring in individuals infected by H. pylori, especially by strains expressing CagA. This infection is more prevalent in individuals with fertility disorders. Infected women have anti-H. pylori antibodies in cervical mucus and follicular fluid that may decrease sperm motility and cross react immunologically with spermatozoa, conceivably hampering the oocyte/sperm fusion. Infection by CagA positive organisms enhances the risk of preeclampsia, which is a main cause of foetus death. These findings are supported by the results of experimental infections of pregnant mice, which may cause reabsorption of a high number of foetuses and alter the balance between Th1 and Th2 cell response. Infected men have decreased sperm motility, viability and numbers of normally shaped sperm and augmented systemic levels of inflammatory cytokines, such as tumor necrosis factor-α, which may damage spermatozoa. In countries where parasitic infestation is endemic, detrimental effects of infection upon spermatozoa may not occur, because the immune response to parasites could determine a switch from a predominant Th1 type to Th2 type lymphocytes, with production of anti-inflammatory cytokines. In conclusion, the evidences gathered until now should be taken into consideration for future studies aiming to explore the possible role of H. pylori infection on human reproduction.

Helicobacter Pylori vacA Gene Detection in Saliva of Patients with Upper Gastrointestinal Disorders in Accra, Ghana

Helicobacter pylori play an essential role in the pathogenesis of upper gastrointestinal disorders. The diagnostic role of the bacterium thus has been a subject of intense investigations. In this study we used an immune-chromatographic method and the polymerase chain reaction (PCR) to detect H. pylori in the saliva of patients with clinically diagnosed upper gastrointestinal disorders. Thirty such patients reporting to the Korle-Bu Teaching Hospital (Accra, Ghana) for upper gastrointestinal endoscopy consented for this study. Saliva samples were collected from each subject and analysed for H. pylori antibodies using a rapid immuno-chromatographic assay and H. pylori DNA by nested PCR using specific primers. Ten (33.3%) out of the 30 samples tested positive for the saliva antibody test with the most prevalent gastrointestinal disorders among the positive subjects being peptic ulcer (60%) followed by gastritis (30%) and esophagitis (10%). Following nested PCR analysis, a 346bp fragment of the vacA (m2) gene region of H. pylori was amplified in 9 (90%) out the 10 samples that were positive by the rapid immuno-chromatographic assay. Saliva samples could serve as a reliable non-invasive alternative to detect the presence of H. pylori infection in synergy with available diagnostic methods in Ghana.

Study of Helicobacter pylori infection and its antibiogram in gastroduodenal disorders in Regional Institute of Medical Sciences Hospital

Objective: Isolation of Helicobacter pylori from biopsy samples taken from cases of gastroduodenal disorder, correlate isolation of H. pylori with urease test, direct modified Grams-stain and H. pylori antibody test, to assess antimicrobial susceptibility pattern of H. pylori isolates. Materials and Methods: Sixty patients with gastroduodenal disorders were included in the study. Urease test, direct modified Grams-stain, H. pylori antibody test, culture and antimicrobial susceptibility were performed as per standard guidelines. Statistical analysis was performed using Fisher's exact test. Results: Antral gastritis was the most common endoscopic findings accounting 43.3%. The study revealed direct Gram-stain positivity of 20%, urease test positivity 46.7%, H. pylori antibody test positivity of 65% and culture positivity rate of 3.3%. Correlation of isolation of H. pylori with Gram-stain found to be significant statistically (P < 0.037). The correlation of isolation with urease test and H. pylori antibody and H. pylori antibody test was statistically not significant. Antimicrobial susceptibility pattern of H. pylori isolates, showed high sensitivity to gentamycin, amoxiclav, tetracycline, clarithromycin, and ciprofloxacin. Higher resistance to metronidazole was observed. Conclusion: Urease test, direct smear, H. pylori antibody test in combination proved to be helpful in the diagnosis of H. pylori infection. Culture from gastric mucosa in infected subjects is low; this could be due to patchy distribution of organisms, prior administration of proton pump inhibitors and antibiotics. Antimicrobial susceptibility testing can be carried out in cases of refractory to treatment.

Frequency of H. pylori Antibodies among Patients with Gastrointestinal Symptoms Attending Khartoum Teaching Hospital- Sudan

A total of 90 patients with gastrointestinal symptoms, and who attended Khartoum Teaching Hospital during the period from April to October 2012, were enrolled in this study. Out of them 35 (38.9%) were males and 55 (61.1%) were females, their age ranges from 15-60 years with mean (33.2). The aim of this study was to detect frequency of Helicobacter pylori IgM, IgG antibodies, and to determine the relationship between the presence of antibodies and certain factors such as (sex, age and genetic susceptibility). 90 serum specimens were collected from patients, and analyzed by ELISA technique. The results showed that 19 (21.1%), 57 (63.3%) were positive for IgM antibody and IgG respectively, while 15 (16.7%) were positive for both. Females were more affected than males, high frequency of positive results was observed among 15-30 age groups. Statistical analysis showed that there was insignificant correlation between age, gender, genetic susceptibility and presence of Helicobacter pylori antibodies (P >0.05).

Helicobacter pylori and gastrointestinal symptoms in diagnostics and adjuvant chemotherapy of colorectal cancer

5-Fluorouracil (5-FU)-based chemotherapy is the mainstay of adjuvant treatment for colorectal cancer (CRC). Few studies have explored Helicobacter pylori (H. pylori)-associated gastrointestinal symptoms in the diagnosis of CRC, and the association between H. pylori infection and gastrointestinal toxicity during adjuvant chemotherapy in CRC. Seventy-nine CRC patients were randomised in a prospective clinical trial to receive 5-FU and leucovorin administered as bolus injection (Mayo regimen) or continuous infusion (simplified de Gramont regimen). H. pylori antibodies were analysed at baseline, twice monthly during treatment and after treatment up to 12 months. Thirty-seven patients (47%) were H. pylori-seronegative at baseline. There was no significant association between baseline H. pylori seropositivity (n=42; 53%) and oro-gastrointestinal toxicity during chemotherapy. The median time from symptom onset of CRC to surgery was significantly longer in patients with H. pylori infection (median time, 6 vs. 5 months; P=0.012). Functional dyspeptic symptoms at presentation significantly delayed diagnosis (median time, 7.5 vs. 5 months; P=0.035), whereas anaemia, bowel symptoms, occlusion, blood in the stool, infection and hypolactasia did not. We conclude that there is no association between H. pylori status and gastrointestinal toxicity in CRC patients during chemotherapy. Dyspeptic symptoms and presence of H. pylori may delay the diagnosis of CRC. (www.controlled-trials.com/ISRCTN98405441).

Study the Relationship between Hemodialysis (HD) Patients and Their ABO Blood Grouping as Well as Screening of Hemodialysis Access-related Bacterial Infections

Aim: This study aimed to study the relationship between hemodialysis patients and ABO blood grouping as well as screening for aerobic bacterial infection. Samples of urine and blood were collected from sixty patients who were submitted to Medical City and Al-kahdemiya hospitals in Baghdad in the period between December 2011 and February 2012. The specimens (urine and blood) were cultured on BHI broth and blood culture media (respectively) and bacterial cultures which were obtained were diagnosed to genus and species using biochemical tests and APi system. Eighty percent of urine samples were positive to culturing while (50%) from the blood samples were positive to culturing. The most isolated bacteria from urine were: Staphylococcus aureus (23%) and Escherichia coli (19.8%) while from blood were S. epidermidis (32.6%) and E. coli (32.6 %). The percentage of the seroprevelence of Helicobacter pylorl was 53% of the total number of HD patients and that 60% of these patients who carried H. pylori antibodies belonged to O blood group. The results also revealed that (55, 25, 10, 10%) of the HD patients were belonging to (O, B, A and AB) respectively.

Helicobacter pylori sero-prevalence in different liver diseases

This study was carried out to investigate the seroprevalence of Helicobacter pylori infection in patients with different liver diseases and determine the association and correlation between the seroprevalence of H. pylori infection and the liver diseases. The presence of a H. pylori antigen was investigated in serum samples from 274 individuals with liver diseases as well as 120 healthy individuals. H. pylori antigen was detected using enzyme-linked immunosorbent assay (ELISA) and Western blot based on specific anti-H. pylori antibody. The result was analyzed using the chi-square test. H. pylori was detected in sera samples of 31.7% (20/63) (X2 = 3.7) of non-cirrhotic, 50% (11/22) (X2 = 3.9) of cirrhotic and 56.1% (106/189) (X2 = 5.2) of hepatocellular carcinoma (HCC) individuals, compared to 8.4% (10/120) of healthy individuals. The levels of H. pyloriantigen were significantly higher (p < 0.05) in sera of different stages of liver diseases compared by healthy individuals. We found a good correlation between H. pylori antigen levels and the severity of the liver diseases (Pathology) (r = 0.368, p < 0.001). Also, there is a correlation between age and H. pylori antigen levels (r = 0.25, p < 0.001). H. pylori infection is correlated with occurrence and development of different stages of liver diseases. Key words: liver diseases, Helicobacter pylori.

Helicobacter hepaticus infection in primary hepatocellular carcinoma tissue

Helicobacter (H.) hepaticus infection causes chronic active hepatitis and induces hepatocellular tumours in A/JCr mice, but evidence of this in humans is scarce. This study aimed to demonstrate the correlation between H. hepaticus and human primary hepatocellular carcinoma (HCC). The sera of 50 patients with primary HCC were tested for the presence of anti-H. pylori and anti-H. hepaticus immunoglobulin G (IgG) antibodies. The liver tissues of patients who tested positive for serum antibody were analysed for H. hepaticus-specific 16S rRNA, H. hepaticus cdtB, H. pylori cagA, H. pylori vacA and H. pylori ureC genes using polymerase chain reaction. After the anti-H. pylori antibodies in the serum samples were absorbed by H. pylori antigen, the anti-H. hepaticus IgG serum antibody detection rate was 50.0% in patients with primary HCC. This was significantly higher (p < 0.001) than the detection rate in the benign liver tumour (7.7%) and normal liver tissue (6.3%) groups. Of the 25 primary HCC samples that tested positive for anti-H. hepaticus IgG serum antibody, the H. hepaticus-specific 16S rRNA gene was detected in nine (36.0%) samples. Sequencing showed that the polymerase chain reaction-amplified product exhibited 95.5%-100% homology to the H. hepaticus-specific 16S rRNA gene. Among these nine primary HCC tissue samples, the H. hepaticus cdtB gene was detected in four (44.4%) samples, while no such expression was observed in the benign liver tumour or normal liver tissue groups. The present study identified the presence of H. hepaticus infection in patients with primary HCC using serological and molecular biological detection, suggesting that H. hepaticus infection may be involved in the progression of HCC.

The association between diabetes mellitus and Helicobacter pylori infection

Helicobacter pylori is a major cause of duodenal and gastric diseases. The aim of this study was to estimate the prevalence of H. pylori infection in patients with diabetes mellitus, and to investigate the association between H. pylori infection and upper gastrointestinal symptoms. In this case-control study, 79 diabetic patients and 84 control subjects with upper gastrointestinal symptoms were included. Upper gastrointestinal endoscopy was performed and gastric mucosa biopsied. H. pylori was identified by rapid urease test and by histology. A serum sample was obtained to measure H. pylori antibodies. The adjusted odds ratio estimates of H. pylori infection among pre-diabetic and diabetic subjects compared to non-diabetic subjects were 0.51 (95 % CI: 0.16, 1.63) and 1.33 (95 % CI: 0.64, 1.79) respectively. No association was found between H. pylori infection and upper gastrointestinal symptoms among three groups. The serology test for H. pylori was positive in 54.4 % (43) of diabetics and 61.4 % (43) of non-diabetic patients (P = 0.689, non-significant). There was significant difference in rapid urease test between diabetes mellitus patients and non-diabetes patients (70.9 % versus 48.6 %, P = 0.002). There was no association between upper gastrointestinal symptoms among diabetes mellitus, pre-diabetic and non-diabetic patients. We found no association between H. pylori infection and diabetes mellitus.

Evaluation of Noninvasive Versus Invasive Techniques for the Diagnosis of Helicobacter pylori Infection

Helicobacter pylori is one of the most common bacterial strains causing chronic infections, affecting over one half of the world's population. There is increasing interest in noninvasive methods for diagnosing H. pylori infection. The aim of the study was to evaluate 3 different noninvasive methods of diagnosis: the stool antigen test (HpSA), the serum antibody test, and the stool-polymerase chain reaction (PCR) test as against invasive methods based on histopathologic diagnosis. Gastric biopsies were obtained during endoscopy. Sections were stained with hematoxylin and eosin and Giemsa stain. Serum samples were tested for H. pylori antibody using an enzyme-linked immnunosorbent assay kit for the semiquantitative determination of IgG antibodies; stool samples were tested for H. pylori antigen using polyclonal enzyme-linked immnunosorbent assay kits. DNA samples from stool specimens were extracted, followed by PCR for the detection of H. pylori UreA. The results revealed that 18/19 (94.7%) patients were positive for H. pylori infection as detected by Giemsa stain, and 84.2% were positive on the basis of hematoxylin and eosin stain, with a sensitivity and specificity of 88.9% and 100%, respectively. Diagnosis by noninvasive methods, including the serum antibody test, revealed a sensitivity and positive predictive value of 88.9% and 94.2%, respectively, whereas the stool antigen test recorded a sensitivity and positive predictive value of 72.2% and 92.9%, respectively. The stool-PCR test recorded a sensitivity of 72.2% and specificity of 100%. Among the noninvasive methods for diagnosis of H. pylori infection, the 3 methods used in this study recorded promising results, including good sensitivity, which was the highest in the serum antibody test, whereas the stool-PCR test recorded excellent specificity.

Seroprevalence of anti-Helicobacter pylori antibodies in population of Sulaimani governorate/Kurdistan Region/Iraq

Helicobacter pylori (H. pylori) infection is one of the most common chronic bacterial infection in the world. Objective: This study was done to assess the extent of H. pylori infection in Suleimani governorate by noninvasive ELISA technique for quantitative detection of anti-H. pylori IgM, IgG and IgA antibodies in serum. Methods: The study included 335 adult and children volunteers from Chamchamal and Sulaimani cities in Kurdistan region / Iraq. The participants answered a structured questionnaire and a blood sample was taken for serological analysis from each participant. The level of serum antibodies for IgM, IgG and IgA were detected using ELISA technique. Results: In the total sample 20.4% had positive IgM, 32.3% positive IgG and 58.2% positive IgA. Two hundred thirty four (74%) subjects had one or more of the antibodies, 138 subjects (41.1%) had at least one antibody positive (IgM 11 (3.2%), IgG 35 (10.4%), IgA 92 (27.4%). In this study 20% had at least two antibodies positive {IgM 25 (7.4%): IgG 45 (13.4%): IgA 64 (19.1%)}. Conclusions: H. pylori infection is common in population of Sulaimani governorate. IgA anti-H. pylori is the most prevalent antibody of population in Sulaimani governorate. The age group of 20-30 years old has the most seroprevalence of antibodies specific to H. pylori.

Prevalence and risk factors of Helicobacter pylori infection in Chinese maritime workers

Background: Helicobacter pylori infection is very common worldwide.Aim: To evaluate the prevalence and identify the risk factors for Helicobacter pylori infection in Chinese maritime workers.Subjects and methods: Between March 2010 and October 2010, 3995 subjects were selected in the Hospital of Dalian Port. The presence of Helicobacter pylori infection was confirmed using laboratory tests (serum IgG anti-Helicobacter pylori antibodies) and background information, family history, lifestyle and eating habits were collected using questionnaires.Results: The prevalence of Helicobacter pylori infection was 44.9% in these Chinese maritime workers. Prevalence of Helicobacter pylori infection was associated with family income, living space, family history of gastrointestinal diseases, smoking, drinking tea, raw vegetables consumption, spicy food, pickle food, dining outside, no regular meal and dish sharing. Further analysis with multivariate logistic regression analysis indicated that raw vegetables consumption, pickle food consumption, family income and family history of gastrointestinal diseases were independent predictors for Helicobacter pylori infection. No association was found between infection and gender, marital status, education, alcohol consumption and tap water consumption.Conclusion: Helicobacter pylori infection is associated with raw vegetables consumption, pickle food consumption, family income and family history of gastrointestinal disease among Chinese maritime workers.

Diagnostic accuracy of urine‐based kits for detection of Helicobacter pylori antibody in children

Rapid urine-HpAb is reported to be a reliable test of Helicobacter pylori infection in adults, but there are no data on the application of the test in children. The aim of this study was to evaluate the accuracy of a urine-based enzyme-linked immunosorbent assay (urine-HpELISA) and immunochromatography (rapid urine-HpAb) kit for anti-H. pylori immunoglobulin G antibody in children. We compared its sensitivity and specificity in reference to the (13) C-urea-breath test (UBT) and H. pylori stool antigen test (HpSA). In total, 101 Japanese children without significant upper-abdominal symptoms were included (mean age, 7.1 years; range 2-15 years). Their sensitivity and specificity were evaluated in reference to the UBT and HpSA. Thirty-seven children were judged H. pylori-positive and 64 negative by the UBT and HpSA. No discrepancy in the results was observed between UBT and HpSA. Urine-HpELISA showed 91.9% sensitivity and 96.9% specificity with an accuracy of 95.0%. Rapid urine-HpAb showed 78.4% sensitivity and 100% specificity with an accuracy of 92.1%. Seven false negative results for rapid urine-HpAb were from children aged younger than 10 years, and their antibody titers of urine-HpELISA were lower than true positives. For the diagnosis of H. pylori infection in Japanese children, both tests are non-invasive, inexpensive, reliable and easy-to-perform methods giving satisfactory accuracy, although the sensitivity of the rapid urine-HpAb kit was inferior to that of the urine-HpELISA kit, especially in children aged younger than 10 years, showing relatively low titer of H. pylori antibody.

Gastric Parietal Cell Antibodies, Helicobacter Pylori Infection, and Chronic Atrophic Gastritis: Evidence from a Large Population-based Study in Germany

Striking similarities between autoimmune gastritis and Helicobacter Pylori (H. pylori)-associated gastritis have suggested a potential link between these two pathologic conditions in the progression of chronic atrophic gastritis (CAG); however, evidence has remained conflicting. Serum pepsinogen I and II, and antibodies against H. pylori in general, the cytotoxin-associated gene A protein (CagA) and parietal cells were measured by ELISA in 9,684 subjects aged 50 to 74 years. Antigastric parietal cell antibody (APCA) prevalence was examined in the overall population and according to sex, age, and H. pylori serostatus. The association between APCA prevalence and CAG was assessed by logistic regression, overall and according to H. pylori status, controlling for potential confounding factors. Overall APCA prevalence was 19.5%. APCA prevalence was strongly associated with CAG, and the association was increasing with increasing severity of CAG. Furthermore, the association between APCA and CAG was even stronger among H. pylori-negative subjects [odds ratio (OR) = 11.3; 95% confidence interval (CI): 7.5-17.1)] than among H. pylori-positive subjects (OR = 2.6; 95% CI: 2.1-3.3). APCA may play a role on the development of gastric atrophy, irrespective of H. pylori infection. Assessment of APCA might be a useful complement to established markers (such as pepsinogens and H. pylori antibodies) in screening for CAG.

Sa1977 A Preliminary Longitudinal Assessment of Mutational Load in Patients With Barrett's Esophagus

INTRODUCTION: Chronic Atrophic Gastritis (CAG) is the most important independent risk condition for gastric cancer, histology being considered the gold standard for both diagnosis and follow up. The Operative Link for Gastritis Assessment (OLGA) is an innovative histological system proposed for staging atrophic gastritis in a prognostic view. GastroPanel (Biohit, Helsinki, Finland) is a serological kit for a non-invasive diagnosis of chronic atrophic gastritis (CAG), including serum pepsinogen I (PGI), pepsinogen II (PGII), gastrin-17 (G17) and IgG anti-Helicobacter pylori antibodies (IgG-Hp). Clinical practice is lacking of a non invasive instrument useful to predict and to follow the stage of atrophic gastritis. AIMS& METHODS: To evaluate correlation between GastroPanel and OLGA stage, in a cohort of dyspeptic patients referred from a primary care setting to our G.I. Unit Histological evaluation of gastric biopsies was performed in 125 pts (83 females, mean age 53 yrs). Atrophy was assessed according to the OLGA staging system. OLGA stages III and IV are considered at high risk for gastric cancer development. From each subject, a blood sample was taken for GastroPanel analysis. RESULTS: GastroPanel analysis showed that 79 pts (63,2%) have no gastritis, 22 pts (17,6%) a Hp-related chronic gastritis and 24 (19,2%) atrophic gastritis picture. Comparing GastroPanel results to the histological findings, 48 pts of the first group were confirmed normal at histology, 27 pts have an OLGA stage 0-II, 4 pts have an OLGA stage III, none stage IV. Among the patients with Hp-related gastritis, 1 pt results normal at the histological evaluation, 20 pts have an OLGA stage 0-II, 1 pt has an OLGA stage III; 6 out of the 24 pts with evidence of CAG at GastroPanel have an OLGA stage 0-II, 18 pts have an OLGA stage III-IV. The negative predictive value (NPV) of GastroPanel for CAG is 95,0%, being the positive predictive value (PPV) 75,0%. CONCLUSION: GastroPanel shows an high NPV to predict absence of atrophic gastritis. The relationship beetween GastroPanel and OLGA system seems to confirm the clinical performances of the test

Helicobacter pylori infection

Helicobacter pylori infection is one of the most common chronic bacterial infections among humans worldwide. However, there is no information on the epidemiology of H. pylori infection in Al Madinah, Saudi Arabia. This study was conducted to determine the seroprevalence of H. pylori in asymptomatic healthy individuals and the possible relationship between H. pylori infection and sociodemographic, lifestyle, and environmental factors in this region. A hospital-based cross-sectional study was conducted on a consecutive sample of asymptomatic healthy individuals. A pilot-tested interview format was used as the research tool. Venous blood was collected from individuals and sera were separated. The enzyme-linked immunosorbent assay was used to determine H. pylori IgG antibody levels in all serum samples. A total of 456 samples were collected. H. pylori antibodies were found in 129 (28.3%) individuals. Seroprevalence of 16.9% was found in individuals younger than 20 years of age, which gradually increased with age and reached 36.8% by the age of 50. After controlling for the confounding factors, significant independent predictors of seropositive state were: rural residence [odds ratio (OR)=2.5, 95% confidence interval (CI)=1.3, 4.7], crowded housing (OR=1.6, 95% CI=1.1, 2.6), low socioeconomic status (OR=3.3, 95% CI=1.6, 8.8), using tanks for drinking water supply (OR=2.2, 95% CI=1.2, 7.4), active smoking (OR=5.6, 95% CI=3.2, 9.8), alcohol drinking (OR=2.3, 95% CI=1.5, 6.2), eating raw vegetables (OR=3.2, 95% CI=1.4, 7.1), eating spicy food (OR=2.1, 95% CI=1.3, 3.5), and presence of asthmatic/atopic symptoms (OR=2.5, 95% CI=1.3, 5.9). No associations were found between infection and age, gender, source of sewage disposal, eating fruits, or family history of upper gastrointestinal symptoms. Infection with H. pylori is declining among healthy individuals of Al Madinah, Saudi Arabia. Infection is acquired at an early age and reaches up to 36.9% as age advances. The risk of H. pylori seropositivity was related to socioeconomic, lifestyle, and environmental factors. A nationwide epidemiological study is warranted to determine the seroprevalence of H. pylori in Saudi Arabia.

Stage IV intramucosal gastric marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type.

A 45-year-old woman with no symptoms underwent upper gastrointestinal endoscopy. A discolored area was noted at the greater curvature of the gastric upper body. Endoscopic ultrasonography demonstrated thickening of the second sonographic layer indicating that the depth of invasion was confined to the mucosa. A urea breath test and anti-Helicobacter pylori antibody test were negative. A computed tomography scan showed a consolidation at the right lung. Gastric biopsy and transbronchial lung biopsy (TBLB) demonstrated a monotonous proliferation of atypical small lymphocytes. A diagnosis of gastric marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type (MALT lymphoma) was made. The clinical stage was stage IV. A genetic analysis showed rearrangement of the joining region of the immunoglobulin heavy chain gene and identical clones in both lesions. An API2-MALT1 fusion gene was detected in the gastric lesion. After H. pylori eradication treatment, combination treatment with rituximab plus CHOP (R-CHOP) was performed; 6months later an endoscopy revealed complete disappearance of the lesion. Multiple gastric biopsies showed no infiltrating atypical lymphocytes. Similarly, the lesion in the lung showed complete remission (CR) on CT and TBLB. This report shows that a gastric MALT lymphoma located in the mucosa and disseminated to the lung maintained CR by R-CHOP.

Significant association of serum H. pylori IgG antibody titer with kidney function in renal transplanted patients.

Introduction: There is a paucity of information about the Helicobacter pylori (H.Pylori) infection in kidney recipients. Objectives: At this study, we sought to investigate the association of some demographic and biochemical indices of kidney transplant patients with serum H. pylori antibody value.Patients and Methods: A total of 72 patients were enrolled in this study. Results: The mean of serum H. pylori IgG antibody titer was 3 ±4.6 U/mL (median= 1 U/mL). A significant positive correlation between serum H. pylori IgG antibody level and creatinine clearance was seen (r = 0.26, P = 0.02). Conclusion: The important finding of this study was the significant positive association of serum H. pylori IgG antibody titer with renal function in renal transplant patient. It means that with gradual loss of kidney function, the probability of H. pylori-infection is increased. Hence, H. pylori infection which is one of the most important and treatable factor leading to a peptic ulcer disease should be treated and eradicated before embarking for transplant.