Cag A seropositivity and the severity of Helicobacter pylori infection in dyspeptic children

• Published in: Acta Paediatrica Vol. 89; no. 11; pp. 1312 - 1315
• Main Authors: Lerro, P, Perrucci, V, Morra, I, Lombardo, L, Gaido, F, Ansaldi, N
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.11.2000
• Subjects: CagA; children; eradication treatment; gastritis; Helicobacter pylori
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/j.1651-2227.2000.tb00756.x

Aim: To assess the incidence of cag A (cytotoxin‐associated protein) and to evaluate its correlation with endoscopic‐histologic findings and with eradication rate in a series of children affected by Helicobacter pylori (H. pylori) gastritis. Methods: Fifty consecutive H. pylori gastritis children (27M; median age 10 y and 11 mo) were tested for IgG cag A protein (Western Blot technique). Pretreatment H. pylori infection was assessed on the grounds of endoscopic antral biopsy specimens by means of rapid urease test and histologic examination (Giemsa staining). All the children were treated with omeprazole (1 mg/kg/d), clarithromycin (15mg/kg/d) and amoxycillin (50 mg/kg/d) for 2 wk. According to universally accepted clinical practice, outcome of treatment was assessed by 13C urea breath test at least 6 wk after the end of therapy. Results: Thirty‐five children (70%) were seropositive to cag A+ protein (median age 11 y and 1 mo). Endoscopic findings of cag A+ patients were similar to those of cag A‐ patients. In cag A seropositive patients the severity of histologic gastritis was higher (p < 0.05) and the granulocytic infiltration more marked (p < 0.01) than in seronegative ones. In cag A+ children, H. pylori eradication rate was significantly lower (p < 0.02). Conclusions: cag A testing may be of useful clinical interest because its positivity can imply a more severe gastritis and a lower susceptibility to eradication treatment.