Аннтотация

© 2018, Dynasty Publishing House. All rights reserved. Objective: to assess diagnostic value of serological tests for Helicobacter pylori detection and to evaluate its feasibility in pediatric gastroenterology. Patients and methods. This study included 850 children aged between 2 and 17 years undergoing inpatient treatment in the Department of Gastroenterology. Participants were diagnosed with chronic gastritis, duodenitis, or esophagitis. All patients underwent a comprehensive examination that included standard blood tests, urine tests, stool tests, fibroesophago and abdominal ultrasonography. H. pylori infection was diagnosed using both invasive and non-invasive methods. Results. Stool tests for H. pylori were positive in 43% of children, which is lower than the estimated infection rate in the Russian population (60%–80%). Analyzing the sensitivity and specificity of various methods for H. pylori detection, we found that the HELPIL test, based on determinig urease activity in the gastric biopsy, was the most accurate one among those evaluated. Serological detection of H. pylori-specific IgM antibodies demonstrated low sensitivity and specificity (32%). However, the analysis of the test results in various age groups showed that this test is highly-sensitive (97%) in children under the age of 6 years. Conclusion. Our findings can be explained by age-related characteristics of the immune response and by the fact that colonization of the gastrointestinal mucosa by H. pylori in children occurs during the development of immunological tolerance to microbiota, which limits inflammatory responses to H. pylori and promotes long-term persistence of bacteria in mucous membranes resulting in chronic inflammation. We recommend paying attention to age-related characteristics of the immune response when choosing a diagnostic option.