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 Lee45   Mi-Kyung Lee6   Hiun Suk Chae7   Hae Kyung Lee8    Helicobacter Study Group   

1 Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine
2 Department of Laboratory Medicine, Yonsei University College of Medicine
3 Department of Laboratory Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul
4 Department of Laboratory Medicine, Konyang University Hospital, Daejeon
5 Department of Laboratory Medicine, Jincheon Sungmo Hospital, Jincheon
6 Department of Laboratory Medicine,Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul
7 Pediatrics Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul
8 Departments of Internal Medicine and 8Laboratory Medicine, Uijeongbu St. Mary's Hospital,College of Medicine, The Catholic University of Korea, Uijeongbu

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   


Acknowledgements

본 연구는 2014년 대한임상미생물학회 연구비 지원을 받아 수행되었음.

Figures & Tables

Fig. 1. Helicobacter pylori stool antigen result by age from 2008 to 2014 in a tertiary care hospital. H. pylori stool antigen was tested by ELISA.


Figures & Tables

Table 1. Positive and equivocal rate of Helicobacter pylori stool antigen by ELISA test from 2008 to 2014 in a tertiary care hospital

CharacteristicsYearTotal
2008200920102011201220132014
Tested samples4044884143373183844172,762
No. of positive samples (%)34 (8.4)35 (7.2)19 (4.6)17 (5.0)29 (9.1)9 (2.3)16 (3.8)159 (5.8)
No. of equivocal samples (%)06 (1.2)11 (2.7)8 (2.4)25 (7.9)7 (1.8)3 (0.7)60 (2.2)