Correlation of serum IgG antibodies to helicobacter pylori in chronic skin disorders: A case-control study

It is known that chronic idiopathic urticaria occasionally develops in association with Helicobacter pylori infection, but this relationship remains unproven. Also, many studies show. We investigated the role of H. pylori infection in patients of chronic idiopathic urticaria, other chronic skin disorders as well as healthy controls using urease breath test and immunoturbidimetry for anti H. pylori IgG antibodies. Three groups of eighty-nine patients each were taken as cases, controls and placebo controls respectively. All patients having IgG titer of 10U/ml or above and Urease Breath Test Positivity were considered positive. : The positive rate of anti H. Pylori IgG antibodies was 78.65% (70/89) in case group, 84.71% (22/89) in controls with other skin disorders and 32.58% (29/89) in placebo control group. While positive rate for Urease Breath Test were found to be 79.8% (71/89) in cases, 35.95% (32/89) in controls with other skin diseases and 32.58% (29/89) in placebo controls. In chronic idiopathic urticaria a high titer of anti H. pylori IgG and Urease Breath Test positivity suggests that inclusion of anti H. pylori therapy in it’s the management would be beneficial and would lead to lower rates of recurrence. Also, low positivity rates of Urease Breath Test and Anti H. pylori IgG in controls with other chronic skin diseases and placebo controls points towards no clear evidence to prove a causal relationship between these diseases and H. pylori infection.

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Development of FlexSure® HP—an immunochromatographic method to detect antibodies against Helicobacter pylori

Clinical Chemistry ◽

10.1093/clinchem/44.2.293 ◽

1998 ◽

Vol 44 (2) ◽

pp. 293-298 ◽

Cited By ~ 9

Author(s):

Wayne H Schrier ◽

Ronald J Schoengold ◽

Josefina T Baker ◽

Joyce L Norell ◽

Corey L Jaseph ◽

...

Keyword(s):

Helicobacter Pylori ◽

Breath Test ◽

Solid Phase ◽

Reverse Flow ◽

Test Strip ◽

Urea Breath Test ◽

Igg Antibodies ◽

Ulcer Disease ◽

13C Urea Breath Test ◽

H Pylori

Abstract We describe a solid-phase immunochromatographic serologic test, FlexSure® HP, to detect IgG antibodies against Helicobacter pylori. H. pylori colonize the stomach and proximal duodenum, cause ulcer disease and mucosa-associated lymphoid tissue lymphoma, and have a role in the development of other disorders, including gastric adenocarcinoma. FlexSure HP consists of a test strip, conjugate pad, and absorbent pad, in a novel reverse-flow chromatography format. In these studies, FlexSure HP was demonstrated to be specific for IgG antibodies against H. pylori. The reactive cutoff of the test was consistent with [13C]urea breath test and commercially available ELISAs. FlexSure HP had 94% sensitivity, 88% specificity, and 91% accuracy relative to [13C]urea breath test; and 95% sensitivity, 94% specificity, and 95% overall agreement relative to high-molecular-mass cell-associated protein enzyme immunoassay (HM-CAP EIA). FlexSure HP is a simple-to-perform, visually read test requiring no specialized training, equipment, or instrumentation, and yields rapid, accurate, qualitative results.

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Correlation between Quantitative 13C-Urea Breath Test and Helicobacter pylori Treatment Success in a Population-Based Cohort

Gastroenterology Research and Practice ◽

10.1155/2018/5439539 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Doron Boltin ◽

Zohar Levi ◽

Tsachi Tsadok Perets ◽

Hemda Schmilovitz-Weiss ◽

Rachel Gingold-Belfer ◽

...

Keyword(s):

Helicobacter Pylori ◽

Breath Test ◽

Treatment Success ◽

Population Based ◽

Urea Breath Test ◽

First Line Therapy ◽

13C Urea Breath Test ◽

Helicobacter Pylori Treatment ◽

H Pylori ◽

First Time

Background. There are continual efforts to identify factors which influence the success of first-line therapy for Helicobacter pylori (H. pylori) infection. The 13C-urea breath test result (C13-UBT) utilizes H. pylori urease activity and is a highly accurate diagnostic assay. We aimed to determine whether the magnitude of C13-UBT result is related to treatment success. Methods. Adult patients who underwent a first-time 13C-urea breath test between January 2010 and January 2016 were included. In order to isolate a naïve test-and-treat population who were unlikely to have undergone an initial endoscopy-based H. pylori test, we excluded patients > 45 years and those with a previous C13-UBT. Data were extracted from the Clalit Health Services laboratory database. Results. A total of 94,590 subjects (36.1% male, age 28.5 ± 6.0 years) who underwent a first-time C13-UBT during the study period were included. C13-UBT was positive in 48,509 (51.3%) subjects. A confirmatory posttreatment C13-UBT was performed in 18,375 (37.8%), and eradication was successful in 12,018 (65.4%). The mean C13-UBT recording was 20.6 ± 16.2 DOB in subjects with successful eradication and 19.5 ± 13.1 DOB in subjects with treatment failure (OR, 1.01; 95% CI 1.00-1.01, p<0.01). Among patients in the upper quintile of C13-UBT measurement, eradication was achieved in 67.6%, compared to 62.6% in the lower quintile (OR, 1.22; 95% CI 1.11-1.35, p<0.01). Subjects in the top 1 percentile (C13-UBT ≥ 70 DOB) achieved eradication in 75.0%, compared to 65.3% among subjects with C13-UBT < 70 DOB (OR, 1.59; 95% CI 1.05-2.41, p<0.01). Conclusions. The superiority in H. pylori eradication observed in subjects with a higher C13-UBT DOB is small but significant. Further studies should examine the physiological and microbiological basis for this finding.

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Study on Association between Chronic Idiopathic Urticaria and Helicobacter Pylori Infection in Armed Forces Personnel

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v12i2.41108 ◽

2016 ◽

Vol 12 (2) ◽

pp. 122-126 ◽

Cited By ~ 1

Author(s):

Md Sayeed Hasan ◽

Md Shirajul Islam Khan ◽

Jannatun Nayeem

Keyword(s):

Helicobacter Pylori ◽

Eradication Therapy ◽

Armed Forces ◽

Case Control ◽

Chronic Idiopathic Urticaria ◽

Helicobacter Pylori Infection ◽

Enteric Infection ◽

Clinical Disorder ◽

Serum Igg ◽

H Pylori

Introduction: Chronic Idiopathic Urticaria (CIU) has an estimated prevalence of 35-65% and impacts 15 to 25% of the population at some point in their lives. Studies have shown the possible involvement of Helicobacter pylori (H. pylori) infection in chronic idiopathic urticaria (CIU), but the relationship remains controversial. Objective: To quantitatively assess the association between H. pylori infection and chronic idiopathic urticaria. Materials and Methods: This was a case-control type of analytical study and 100 patients were enrolled fifty patients of CIU fulfilling inclusion criteria with no identifiable cause were taken as case and patients without urticaria were taken as control, attending in the department of Dermatology & Venereology, CMH Dhaka for treatment from May 2015 to Aug 2016. Helicobacter pylori infection was confirmed by serum IgG for H. pylori test. Results: The result showed that H. pylori infection significantly affected a high percentage of patients 30 (60%) with chronic idiopathic urticaria. Male respondents were more positive 16(53.3%) than female 14(46.7%), in the middle aged 31-50 year about 18(60%) and triple drug therapy was successful in 16(53.33%) patients in whom H. pylori was detected. Conclusion: Urticaria is a common clinical disorder with complex triggering factors. Chronic urticaria has provided evidence that enteric infection with H. pylori may induce the disease. In this case control study, it was evident that chronic idiopathic urticaria was associated with positive serum IgG for H. Pylori. A trial of H. pylori eradication therapy may be offered to patients with CIU and evidence of H. pylori infection. Journal of Armed Forces Medical College Bangladesh Vol.12(2) 2016: 122-126

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Influence of Helicobacter pylori Infection on the Small Intestinal Mucosa

ISRN Endoscopy ◽

10.5402/2013/408931 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5

Author(s):

Mitsunori Maeda ◽

Masakazu Nakano ◽

Hideyuki Hiraishi

Keyword(s):

Helicobacter Pylori ◽

Negative Relationship ◽

Mucosal Injury ◽

Enzyme Linked Immunosorbent Assay ◽

Small Intestinal Mucosa ◽

Significant Negative Relationship ◽

Positive Rate ◽

Intestinal Mucosal Injury ◽

Small Intestinal ◽

H Pylori

Background/Aims. To investigate the role of Helicobacter pylori infection in the development of enteritis (small intestinal mucosal injury). Methodology. Between April 2007 and January 2013, 99 patients undergoing capsule endoscopy (CE) were tested for anti-H. pylori immunoglobulin G antibody (Hp-IgG) using an enzyme-linked immunosorbent assay (ELISA). None of the patients had been treated for H. pylori infection or diagnosed as having Crohn’s disease or any other clinically apparent small intestinal disorders prior to the CE. Results. The overall Hp-IgG-positive rate was 26.3%. The incidence of enteritis, as diagnosed by CE, tended to be lower in the Hp-IgG-positive patients (23.1%) than in the Hp-IgG-negative patients (38.4%) (). When patients receiving aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), well-known causes of enteritis, were excluded, the incidence of enteritis in the Hp-IgG-positive patients (11.7%) was significantly lower than that in the Hp-IgG-negative patients (43.7%) (). A binomial logistic regression analysis revealed a significant negative relationship between Hp-IgG positivity and the presence of enteritis in patients receiving neither aspirin nor NSAIDs (). Conclusions. Our data indicated that H. pylori positivity was inversely associated with the prevalence of enteritis.

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Preliminary Serological Study of Helicobacter pylori Infection in Some University Students

Recent Advances in Biology and Medicine ◽

10.18639/rabm.2020.958557 ◽

2020 ◽

Vol 6 ◽

pp. 1

Author(s):

Abdullah A Mahrazi ◽

Mohammad A Khibrani ◽

Khatib S Ismail ◽

Emad Abada ◽

◽

...

Keyword(s):

Helicobacter Pylori ◽

University Students ◽

Large Scale ◽

Confirmatory Test ◽

Enzyme Linked Immunosorbent Assay ◽

Blood Collection ◽

Igg Antibodies ◽

Igm Antibodies ◽

H Pylori

Helicobacter pylori has been associated with peptic ulcer and gastric carcinoma. This study aimed to find the seroprevalence of H. pylori infection in some male students of Jazan University, Saudi Arabia. Twenty students were enrolled in the study (n = 20). Informed consent was obtained from the students. About 2 ml blood was collected intravenously in Improvacuter® evacuated blood collection tubes. The blood was allowed to clot at room temperature. The serum was collected and stored at –20°C for further use. The separated serum was used to detect IgG and IgM antibodies by Enzyme Linked Immunosorbent Assay (ELISA) against H. pylori for the in vitro diagnosis. A total of 11 (55.00%) students tested positive for IgG antibodies against H. pylori indicating previous infection. All the samples tested negative for IgM antibodies against H. pylori indicating no active infection. The seroprevalance of IgG antibodies against H. pylori was found to be very high in some male university students and is a cause of concern regarding their health. Obesity (p < 0.05; Value statistically significant), stress and bad eating habits, eating out, drinking carbonated beverages, and eating spicy food were some of the factors found to be associated with IgG seropositive students. The students were counseled and were instructed to undergo a confirmatory test and get medical intervention. Further large-scale studies need to be performed to plan action against this disease causing organism and to improve the health of students.

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Helicobacter pylori causes gastrointestinal hemorrhage in patients with congenital bleeding disorders

Thrombosis and Haemostasis ◽

10.1055/s-0037-1613581 ◽

2003 ◽

Vol 89 (04) ◽

pp. 741-746 ◽

Cited By ~ 7

Author(s):

Ann-Sofie Rehnberg ◽

Marju Hein ◽

Olga Hegedus ◽

Per Lindmarker ◽

Per Hellström ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gastrointestinal Hemorrhage ◽

Breath Test ◽

Eradication Therapy ◽

Urea Breath Test ◽

Von Willebrand Disease ◽

Bleeding Disorders ◽

Ulcer Disease ◽

H Pylori ◽

One Year

Summary Helicobacter pylori (H. pylori) infection is associated with peptic ulcer disease and gastric cancer. The eradication of H. pylori is of special interest in patients with congenital bleeding disorders, for whom treatment of gastrointestinal hemorrhage with factor concentrates is costly. The prevalence of H. pylori varies between different populations and identification of high-risk subgroups may allow for more targeted screening and eradication of the infection. We performed a 5-year retrospective study of gastrointestinal bleeding, combined with screening and treatment for H. pylori and a long-term prospective follow-up in 168 Swedish and 23 Estonian patients with hemophilia or von Willebrand disease. The prevalence of seropositivity was lower in Sweden than in Estonia (28 versus 48%, p = 0.03), lower in native Swedes than in non-Nordic immigrants to Sweden (20 versus 76%, p = 0.0001) and lower in patients less than 40 years of age than older patients (16 versus 38%, p = 0.002). The incidence of gastrointestinal hemorrhages among the 35 Swedish patients with active H. pylori infection, confirmed by a urea breath test, was 6.0 per 100 patient-years before eradication therapy versus 1.7 during the prospective followup. A negative urea breath test one month after therapy always remained negative after one year. Screening, followed by treatment of all infected patients, yielded a reduction of direct costs over a 5-year period of 130 US-$ per screened patient. We conclude that screening and eradication therapy for infection with H. pylori in patients with congenital bleeding disorders is an effective and economic strategy.

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Serology Is More Sensitive Than Urea Breath Test or Stool Antigen for the Initial Diagnosis of Helicobacter pylori Gastritis When Compared With Histopathology

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqaa043 ◽

2020 ◽

Vol 154 (2) ◽

pp. 255-265

Author(s):

Dustin E Bosch ◽

Niklas Krumm ◽

Mark H Wener ◽

Matthew M Yeh ◽

Camtu D Truong ◽

...

Keyword(s):

Helicobacter Pylori ◽

Access To Care ◽

Breath Test ◽

Diagnostic Error ◽

Urea Breath Test ◽

Positive Serology ◽

Noninvasive Test ◽

Stool Antigen ◽

And Performance ◽

H Pylori

Abstract Objectives To assess the concordance and performance characteristics of Helicobacter pylori laboratory tests compared with histopathology and to propose algorithms for the diagnosis of H pylori that minimize diagnostic error. Methods H pylori diagnostics were reviewed from a 12-year period within a health system (2,560 cases). Analyses were performed to adjust diagnostic performance based on treatment and consensus histopathologic diagnoses among pathologists. Markers of access to care, including test cancellation frequency and turnaround time, were assessed. Costs and performance of candidate noninvasive testing algorithms were modeled as a function of disease prevalence. Results Serum H pylori IgG demonstrated a higher sensitivity (0.94) than urea breath and stool antigen tests (0.64 and 0.61, respectively). Evidence of an advantage in access to care for serology included a lower cancellation rate. Interobserver variability was higher (κ = 0.34) among pathologists for cases with a discordant laboratory test than concordant cases (κ = 0.56). A model testing algorithm utilizing serology for first-time diagnoses minimizes diagnostic error. Conclusions Although H pylori serology has modestly lower specificity than other noninvasive tests, the superior sensitivity and negative predictive value in our population support its use as a noninvasive test to rule out H pylori infection. Reflexive testing with positive serology followed by either stool antigen or urea breath test may optimize diagnostic accuracy in low-prevalence populations.

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The Patterns and Associated Cost of Serologic Testing for Helicobacter pylori in the U.S. Military Health System

Military Medicine ◽

10.1093/milmed/usaa141 ◽

2020 ◽

Vol 185 (9-10) ◽

pp. e1417-e1419

Author(s):

Kevin Pak ◽

Zachary Junga ◽

Andrew Mertz ◽

Manish Singla

Keyword(s):

Helicobacter Pylori ◽

Clinical Utility ◽

Igg Antibodies ◽

Military Health System ◽

Military Health ◽

Igm Antibodies ◽

Serologic Testing ◽

Stool Antigen ◽

H Pylori ◽

The U.S

Abstract Introduction Helicobacter pylori (H. pylori) infection affects about half of the world’s population and can lead to multiple complications if left untreated. Testing for H. pylori infection in appropriate patients with prompt treatment followed by the testing of eradication is the standard of care in the United States. Active Duty Service members (ADSMs) in the U.S. military are a unique patient population that may be at higher risk for acquiring H. pylori infection given frequent deployments to developing countries. Noninvasive diagnostic strategies include the urea breath test, the stool antigen test, and serologic testing, which include H. pylori immunoglobulin M (IgM), immunoglobulin A (IgA), and immunoglobulin G (IgG) antibodies. Among noninvasive methods, the least sensitive is serology, and although there is clinical utility in testing for H. pylori IgG antibodies, H. pylori IgA or IgM antibodies have limited clinical utility. Despite this, H. pylori IgA and IgM antibodies are still widely ordered across the Military Health System. Materials and Methods In order to determine how frequently this testing is being ordered and the associated cost, we conducted a retrospective cross-sectional study of H. pylori serologic testing utilization in the MHS from October 2015 to September 2018 in adult patients using the MHS Data Repository. All H. pylori IgM, IgA, and IgG antibodies, H. pylori stool antigen tests, and H. pylori urea breath tests were queried during this time period across all ADSMs, retirees, and ADSM dependents for all adults. Cost information was obtained from LabCorp, and the institutional price used for cost analysis was the same throughout all military treatment facilities in the Department of Defense (DOD). Results We discovered that over a 3-yr period, 1,916 H. pylori IgA and 2,492 IgM antibodies were ordered. In total, the DOD spent close to $400,000 on antibody-based testing for H. pylori not accounting for indirect associated costs like personnel, supplies, repeat testing, as well as the costs of delayed diagnosis and associated complications. Conclusion H. pylori IgM and IgA have limited clinical utility, are inaccurate, and are costly to maintain, especially when more accurate alternative tests are available. Based on our analysis, we strongly recommend the removal of the H. pylori IgA and IgM serologic tests throughout the DOD in order to improve the efficiency and quality of care for patients suspected of having an H. pylori infection. Further research is needed to determine how these tests are ordered, how providers are responding to the results of the serologic tests, and if noninvasive testing is being ordered appropriately.

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Chronic Pruritus Associated with Helicobacter Pylori

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540200600202 ◽

2002 ◽

Vol 6 (2) ◽

pp. 103-108

Author(s):

Roshini Kandyil ◽

Nadia S. Satya ◽

Robert A. Swerlick

Keyword(s):

Helicobacter Pylori ◽

Antibiotic Therapy ◽

Breath Test ◽

Urea Breath Test ◽

Complete Relief ◽

Active Infection ◽

Temporary Relief ◽

Chronic Pruritus ◽

H Pylori

Background: Helicobacter pylori is an established cause of gastritis and has been implicated in extradigestive diseases. Objective: To investigate the role of H. pylori in patients with unexplained refractory pruritus. Methods: Ten patients with severe pruritus unresponsive to conventional therapy were evaluated for active H. pylori infection by H. pylori serology followed by either esophagogastroduodenoscopy (EGD) or urea breath test. Of the 10 patients, 8 were found to have active infection. All 10 received anti- H. pylori antibiotic therapy and were reevaluated for relief of pruritus. Results: Of 8 patients with active H. pylori infection, 87.5% (7/8) had some type of pruritus relief after triple therapy. Of these, 62.5% (5/8) had complete relief and 25% (2/8) had temporary relief of pruritus. The remaining 12.5% (1/8) did not respond. Two control patients without active H. pylori infection had no relief of pruritus with therapy. Conclusions: We have identified a population of patients with refractory pruritus and active H. pylori infection whose pruritus resolved after eradication of H. pylori.

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Correlates of infection with Helicobacter pylori positive and negative cytotoxin-associated gene A phenotypes among Arab and Jewish residents of Jerusalem

Epidemiology and Infection ◽

10.1017/s0950268819001456 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 2

Author(s):

K. Muhsen ◽

R. Sinnereich ◽

G. Beer-Davidson ◽

H. Nassar ◽

W. Abu Ahmed ◽

...

Keyword(s):

Helicobacter Pylori ◽

Former Soviet Union ◽

Enzyme Linked Immunosorbent Assay ◽

Igg Antibodies ◽

Multinomial Regression ◽

Igg Antibody ◽

Sibship Size ◽

Cross Sectional ◽

Cytotoxin Associated Gene A ◽

H Pylori

Abstract We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%–85.5%) and 61.4% (95% CI 57.7%–65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%–45.8%) and 32.5% (95% CI 28.2%–37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.

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