B. Khanna et al., USE CAUTION WITH SEROLOGIC TESTING FOR HELICOBACTER-PYLORI INFECTION IN CHILDREN, The Journal of infectious diseases, 178(2), 1998, pp. 460-465
Commercial serologic assays accurately detect adult Helicobacter pylor
i infection. Their use in children remains controversial. An ELISA to
detect H, pylori IgG in children was developed and compared with three
commercial assays. ELISA standardization was done with sera from all
ages and validation was done with another cohort of sera with known H,
pylori status. Three commercial serologic assays were subsequently co
mpared against this pediatric ELISA at independent sites, at which 142
pediatric serum samples from different countries were evaluated. The
pediatric ELISA was 91.4% sensitive. Assay 3 demonstrated a sensitivit
y of 78%. Less sensitivity was observed for assay 1 (70%) and assay 2
(63%). Accuracy of commercial assays was greatly reduced when sera fro
m developing countries and younger ages were evaluated. Results of ser
ologic tests used to diagnose H, pylori should be interpreted with cau
tion when evaluating children with abdominal pain. Accurate serologic
assays in children may be more important for epidemiologic research th
an for clinical decision making.