ISSN:
1573-2568
Keywords:
HELICOBACTER PYLORI
;
SCREENING
;
SEROLOGY
;
ELISA
;
UPPER GASTROINTESTINAL ENDOSCOPY
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract The objective of this study was to test thefeasibility of a screening strategy for IgG antibodiesagainst Helicobacter pylori in patients presenting withupper abdominal complaints. Biopsy specimens were taken for histological and microbiologicalinvestigations from consecutive patients undergoingupper gastrointestinal endoscopy. In addition, a serumsample was taken for detection of IgG antibodies against Helicobacter pylori, using an ELISA technique.Serum samples from 1294 consecutive patients wereavailable. IgG antibodies against Helicobacter pyloriwere present in 622 patients (48%), the remaining 671 (52%) were negative. If endoscopy had beenomitted in seronegative patients below the age of 45years, this would have resulted in 234 patients notendoscoped. However, it can be assumed that 62 of these patients would undergo endoscopy becauseof recurrent complaints due to underlying disease orabnormality. Therefore 182 of 1294 (14%) of endoscopieswould have been avoided. Application of this strategy on the total group of seronegatives would save353 of 1294 (27.3%) endoscopies. If endoscopy had beenomitted in seropositive cases below the age of 45 years,and these patients were treated with anti-Helicobactertherapy, an initial 145 endoscopies would have beenavoided. However, 26 of these patients would undergoendoscopy because of persistent complaints due tounderlying disease. Therefore 119 (9%) endoscopies would have been avoided.Applying this strategy in the total group ofseropositives would have saved 434 of 1294 endoscopies(34%). Applying the IgG screening strategy in allpatients would result in a significant number of endoscopiesbeing avoided in the seropositive group, 434 versus 353(P 〈 0.001). In conclusion, omitting endoscopy inseropositive cases, regardless of age, can reduce the workload more than omitting endoscopy inseronegative cases: 34% fewer endoscopies versus27%.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1026683026028
Permalink
