Tuğçin B. POLAT, Feride SELÇUKCAN, Füsun N. YENİCİ, Nafiye URGANCI

Çocuklarda helicobacter pylori enfeksiyonunda noninvaziv yöntemlerin tanı ve tedavi sonrası takipte etkinliği

Bu çalışmada çocuklarda C14 üre nefes testi (ÜNT) ve kan seroloji testinin helicobacter pylori (HP) infeksiyonu tanısı koymaktaki etkinliğini değerlendirmeyi amaçladık. Gereç ve Yöntem : Tekrarlayan karın ağrısı şikayeti ile başvuran, HP pozitifliği C14 ÜNT ve/veya seroloji pozitifliği ile saptanmıs toplam 112 çocuk çalışmaya dahil edildi ve olgulara histopatolojik değerlendirmeyle kesin tanı konuldu. 102 olguda tanı doğrulanıp tedavi başlandı. Tedavi sonrası tüm olgulara testler tekrarlandı ve pozitif bulunan 32 olguda histopatolojik inceleme tekrarlanarak 21 'inde tanı doğrulandı. Bulgular: C14 ÜNT'nin HP tanısı koymada duyarlılığı % 98,2 ve özgüllüğü % 90 olarak saptandı. HP tanısında serolojinin sensivitesi % 87.3 özgüllüğü % 80 olarak bulundu ve 7 yasından küçük olgularda yanlış negatiftik oranı (%3 6) oldukça yükselmekteydi. HP tedavi basarısı %79.5 olarak saptandı. Tedavi sonrası C14 ÜNT'nin HP tanısı koymada duyarlılığı % 95.2 ve özgüllüğü % 90 bulundu buna rağmen serolojinin özgüllüğü (% 64.5) oldukça düşüktü. Sonuç: HP tanısında serolojik değerlendirmenin özellikle erken çocuklu döneminde yanlış negatif sonuçları artmaktadır, ayrıca tedavi sonrası takiplerde yanlış pozitiflik oranlan oldukça yüksektir, Bu sebeple çocuklarda hem tanı hemde takipte iyi bir yöntem değildir. C14 ÜNT HP enfeksiyonu süphesi olan, özellikle uyum sorunu yaşanmayan her yas grubu çocukta histopatolojik değerlendirmeyle uyumlu sonuçlar vermektedir, tanı ve tedavi sonrası takipte yeterli bir tanı aracıdır.

Efficacy of non-invasive tests in the diagnosis and post-treatment follow-up of helicobacter pylori infection pediatric patients

Purpose: Helicobacter pylori (HP) infection is generally acquired in early childhood and is responsible for 15% of cases of peptic ulcus during their lifetime. Furthennore, recurrence of infection after successful eradication is two-fold more common in children than in adults. Therefore, widely applicable and sensitive diagnostic : tests are required for children. We aimed to evaluate the C14 urea breath test (UBT) aid blood serology test for the diagnosis of HP infection in children. Materials and Methods: This study included 112 children with recurrent abdominal pain, in whom positive HP results were obtained with CI4 UBT and/or blood serology test. The diagnosis was confirmed histopathologically in 102 patients and they were treated. C14 UBT and/or blood serology test results were positive in 32 of the 102 patients after treatment and the diagnosis was confirmed in 21 of those 32 patients by repeated histopathological analysis. Results: The sensitivity and specificity of C14 UBT were 98.2% and 90%, and the sensitivity and specificity of HP blood serology were 87.3% and 80%, respectively. Hie blood serology test had a higher false-negative rate (36%) in children under seven years of age for predicting HP infection. HP treatment success was 79.5%. The ,C14 UBT had higher sensitivity and specificity (95.2% and 90%, respectively), whereas Hie blood serology had an unacceptably low specificity (64.5%) after treatment. Conclusion: False negative results are higher on evaluation of serology on diagnosis of HP infection in early childhood, and false positive results are higher during follow-up after treatment. Therefore, serology is not a reliable tool for the diagnosis and follow-up in children. C1.4 UBT results are compatible with histopathologic findings on diagnoses of HP, particularly for cooperative children of all ages; thus it is sufficient for diagnosis and post-treatment follow-up.

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