Introduction



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      • Comparative evaluation of conventional methods and Elisa based IgG antibodies detection for diagnosis of helicobacter pylori infection in cases of dyspepsia
      • Arora u.et al,
      • Indian Journal of Medical Microbiology
      • Year : 2003  |  Volume : 21  |  Issue : 1 

INTRODUCTION

  • Helicobacter pylori is a gram negative,spiral flagellated bacterium that colonizes the human stomach.

  • Presently, its role has been established in chronic antral gastritis, duodenal ulcer, chronic gastric ulcer, dyspepsia, gastric cancer and gastric lymphoma.

  • World Health Organization added H.pylori to its list of known carcinogens.



INTRODUCTION

  • The diagnosis of H.pylori infection is currently based upon endoscopic biopsy based invasive tests (Rapid urease, culture, Gram staining and histopathology)

  • Non invasive, serology based tests detecting IgG antibodies (since H.pylori causes chronic infection) are commercially available.



INTRODUCTION

  • AS invasive procedures are tedious hence every person complaining of symptoms suggestive of gastroduodenal disease cannot be subjected to these tests

  • The present study was therefore planned for comparative evaluation of conventional methods and ELISA based IgG antibody detection by a commercially available kit for diagnosis of H.pylori infection in cases of dyspepsia



Materials and Methods

  • Subjects: 75 dyspeptic patients

  • Specimen:

  • Gastric biopsy specimen

  • Serum samples

  • Tests procedures :

  • Biopsy specimens were processed for rapid urease test, gram staining and culture.

  • Serum samples were used for detecting IgG antibodies against 128kDa external protein (Cag A) of H.pylori using a commercially available ELISA kit.



Results

  • Type of Test Patients ( n = 75 )

  • Positive Percentage

  • Rapid urease test : 54 72%

  • Gram staining 15 20%

  • Culture 21 28%

  • Significant IgG titres (20U/ml) 57 76%



Discussion

    • The difficulties associated with invasive test and low isolation rate of this organism has led to the development of various serological test
    • Results of positive serology also comparable with biopsy based RUT which at present is most commonly used test for diagnosis of H.pylori infection


Discussion

  • No case was detected in which rapid urease test was positive but serology insignificant.

  • Three cases were negative by rapid urease test, but had significant IgG levels. This may be due to……



Conclusion

  • We recommend serology as a screening procedure only and if the titres are insignificant, the role of endoscopy just to make a diagnosis of H.pylori infection in dyspeptic patients is not warranted.



  • THANKS TO ALL



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