Clin Pediatr Phila

Clin Pediatr Phila. Enzygnost II IgG, Pyloriset IgG, Enzygnost II IgA, and Pyloriset IgA, respectively. Sensitivity was low in the youngest age group (25 to 33.3%), except for Enzygnost II IgG (91.6%). Receiver-operating curve analyses revealed that lower cutoff values would improve the accuracy of all of the tests except Enzygnost II IgG. Measurement of specific IgA, in addition to IgG, antibodies hardly improved the sensitivity. CD2 The specificity of commercial serological assessments is high in children when the cutoff values obtained from adults are used. In contrast, sensitivity is variable, with a strong age dependence in some, but not all, assessments. We speculate that young children may have a different immune response to contamination is usually acquired in child years and is the main cause of active chronic gastritis and peptic ulcer disease in both adults and children (3, 8, 10, 19, 30). The infection induces cellular and humoral serum immune responses in most patients, and measurement of specific antibodies in serum has been used as a noninvasive method by which to detect contamination. Specific immunoglobulin M(IgM) antibodies can be detected shortly after Plantamajoside the infection is usually acquired, but IgA and IgG titers show chronic contamination (5). Serological assessments are commercially available, easy to perform, and inexpensive and therefore have been recommended for the diagnosis of contamination in adults (1, 19). Many serological assessments, mainly IgG based, have been validated in adult populations against invasive methods with acceptable sensitivity and specificity for clinical use (11, 13, 20). Studies of children showed controversial results, with a large sensitivity range of 50 to 96% and specificity ranging from 83 to 100% (2, 5, 16, 21C23, 28). Most of the investigators used an in-house enzyme immunoassay (EIA) with a cutoff value adapted to the pediatric populace under consideration. Using a commercially available EIA on 68 Brazilian children, Oliveira et al. observed a strong relationship between the age of a child and sensitivity (21). In children older than 12 years, the sensitivity was 93%, but in children between 2 and 6 years of age, this value decreased to 44%. Because of the controversial results obtained with children, the consensus statement of the European Society of Pediatric Gastroenterology, Hepatology and Plantamajoside Nutrition and the European Study Group considered serological testing to be less reliable for children than for adults, but further validation studies and improvement of assessments are warranted (10). The purpose of this study was to evaluate two commercially available second-generation EIAs, both for IgG and IgA, for the diagnosis of contamination in symptomatic children of different ages and nationalities living in Germany. Enzygnost II is the most widely used enzyme-linked immunosorbent assay in Germany (according to data from your German nationwide Instand external quality control). Pyloriset was one of the most popular assessments before Enzygnost II was launched to the German market. MATERIALS AND METHODS Patients. The study group included 178 children aged 9 months to 19 years (mean standard deviation [SD], 9.2 4.3 years) who underwent upper endoscopy for evaluation of symptoms suggestive of upper gastrointestinal tract disease. Symptoms included recurrent upper abdominal pain, heartburn, regurgitation, vomiting, and hematemesis. A 13C-urea breath test (UBT) was performed on all patients. The following data were obtained: age, sex, nationality, previous eradication therapy, and medication (acid-suppressive drugs, antibiotics) during the 4 weeks prior to endoscopy. Only patients without previous treatment for contamination were included. UBT. The UBT was performed in accordance with our previously explained protocol (17). In brief, after a fasting period of at least 4 h, each child drank 150 ml of refrigerated (6C) apple juice (pH 3.4). Thereafter, the child ingested 75 mg of 13C-labeled urea (Eurosotop, Paris, France; 99% chemical purity) dissolved in 20 ml of apple juice and then drank another 30 ml of juice to rinse the mouth. Before (baseline) and 15 and 30 min after tracer application, the child was asked to blow into a breath bag (Medicheck, Essen, Plantamajoside Germany). For young and disabled children, a face mask was utilized for breath sampling. Aliquots of expiratory air flow were transferred into 10-ml Vacutainers. The ratios of 13C to 12C were measured by isotope ratio mass spectrometry (Finnigan MAT delta S, Bremen, Germany). The difference between the value at 15 or 30 min and the baseline was expressed as delta over baseline (per mille). The UBT was defined as positive for contamination if the 15- and/or 30-min value was.