Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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pISSN 2288-0585 eISSN 2288-6850

Multicenter Study on the Association of Positive Helicobacter pylori Stool Antigen to Anemia in Children

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2018 September, Volume 21, Issue 3, pages 58-63.

https://doi.org/10.5145/ACM.2018.21.3.58

Multicenter Study on the Association of Positive Helicobacter pylori Stool Antigen to Anemia in Children

Heungsup Sung1, Mi-Na Kim1, Dongeun Yong2, Miae Lee3, Jongwook Lee4,5, Mi-Kyung Lee6, Hiun Suk Chae7, Hae Kyung Lee8, Helicobacter Study Group
1Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, 2Department of Laboratory Medicine, Yonsei University College of Medicine, 3Department of Laboratory Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, 4Department of Laboratory Medicine, Konyang University Hospital, Daejeon, 5Department of Laboratory Medicine, Jincheon Sungmo Hospital, Jincheon, 6Department of Laboratory Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Departments of 7Internal Medicine and 8Laboratory Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea

Abstract

Background: Helicobacter pylori infection in children causes gastrointestinal symptoms and iron deficiency anemia. This study aimed to investigate trends in H. pylori stool antigen (HpSA) positivity in children and the relationship between HpSA test results and anemia.

Methods: We analyzed the results of 2,762 HpSA tests and the correlation of hemoglobin and ferritin with HpSA in patients aged 0-18 years from 2008 to 2014 at a tertiary care center. Additionally, we prospectively evaluated HpSA test results and correlation with hemoglobin in 352 specimens obtained from five centers.

Results: From 2008-2014, the mean positive rate of the HpSA test was 5.8%, with a high of 9.1% in 2012 and a low of 2.3% in 2013. The positive rate correlated with age: 2.9% in 0-6-year-olds, 5.8% in 7-12-year-olds, and 10.6% in 13-18-year-olds (P<0.0001). There was no difference in HpSA positivity in patients with (7.0%) and without (5.7%) anemia. Ferritin was significantly lower in patients with positive HpSA results than in those with negative results (P=0.0001). In a multicenter study, the positive rate of HpSA was 16.8%.

Conclusion: The rate of HpSA positivity was 5.8% in pediatric patients at a single center from 2008-2014, and this rate increased with age. Helicobacter pylori infection may be associated with iron deficiency, as ferritin level was significantly lower in HpSA-positive patients than HpSA-negative patients. (Ann Clin Microbiol 2018;21:58-63)

Keywords

Anemia, Ferritin, Helicobacter pylori, Hemoglobin, Stool antigen