Helicobacter pylori infection, serum pepsinogens, and pediatric abdominal pain: a pilot study

Eias Kassem, Medhat Naamna, Kadri Mawassy, Gany Beer-Davidson, Khitam Muhsen

Research output: Contribution to journalArticlepeer-review

Abstract

The significance of Helicobacter pylori (H. pylori) infection in pediatric abdominal pain remains poorly recognized. We examined associations of H. pylori infection and serum pepsinogens (PGs), as non-invasive markers of gastritis, with pediatric abdominal pain. A case-control study was conducted among 99 children aged 5–17 years admitted to one hospital for abdominal pain (cases) without an apparent organic reason. Using enzyme-linked immunosorbent assays, sera were tested and compared with 179 controls for anti-H. pylori immunoglobulin G (IgG) antibodies and PGI and PGII levels. Multivariable analysis was performed to adjust for potential confounders. H. pylori IgG sero-positivity was 34.3 and 36.3% in cases and controls, respectively, P = 0.7. H. pylori-infected children had higher median PGI and PGII levels and a lower PGI/PGII ratio than uninfected children. Cases infected with H. pylori had a higher median PGII level (P < 0.001) and lower PGI/PGII ratio (P = 0.036) than controls infected with H. pylori. The percentage of cases with PGII ≥7.5 μg/L, as indication for antral inflammation, was higher than in controls: 58.6 versus 44.7%, P = 0.027. Children with PGII levels ≥7.5 μg/L had increased risk for abdominal pain: adjusted prevalence ratio 1.73 [95% confidence intervals 1.02, 2.93], P = 0.039. Conclusion: Children with increased serum PGII levels, as an indication of gastritis, are more likely to have abdominal pain. Serum PGs can be a useful non-invasive marker for gastritis, in evaluating children with severe abdominal pain with no apparent organic reason.What is Known:• The significance of Helicobacter pylori infection in pediatric abdominal pain remains debated.• Serum pepsinogens (PGs), non-invasive markers of gastric inflammation, were rarely utilized in assessing the association between H. pylori in pediatric abdominal pain of unknown origin.What is New:• High serum PGII level, as an indication of gastritis, rather than H. pylori infection itself, was associated with increased risk for abdominal pain.• Serum PGs can be a useful biomarker for gastritis in evaluating children with severe abdominal pain with no apparent organic reason.

Original languageEnglish
Pages (from-to)1099-1105
Number of pages7
JournalEuropean Journal of Pediatrics
Volume176
Issue number8
DOIs
StatePublished - 1 Aug 2017

Keywords

  • Abdominal pain
  • Case-control study
  • Children
  • H. pylori
  • Serum pepsinogen

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

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