Pre-endoscopic screening for Helicobacter pylori and celiac disease in young anemic women

AIM:To evaluate the usefulness of pre-endoscopic serological screening for Helicobacter pylori(H pylori) infection and celiac disease in women aged<50 years affected by iron-defi ciency anemia(IDA).METHODS:One hundred and fi fteen women aged<50 years with IDA were tested by human recombinant tissue transglutaminase IgA antibodies(tTG) and anti-H pylori IgG antibodies.tTG and H pylori IgG antibody were assessed using an enzyme-linked immunosorbent assay(ELISA).All women were invited to undergo upper GI endoscopy.During gastroscopy,biopsies were collected from antrum(n=3),gastric body(n=3) and duodenum(n=4) in all patients,irrespective of test results.The assessment of gastritis was performed according to the Sydney system and celiac disease was classifi ed by Marsh's System.RESULTS:45.2% women were test-positive:41 patients positive for H pylori antibodies,9 patients for tTG and 2 patients for both.The gastroscopy compliance rate of test-positive women was significantly increased with respect to those test-negative(65.4% vs 42.8%;Fisher test P=0.0239).The serological results were confi rmed by gastroscopy in 100% of those with positive H pylori antibodies,in 50% of those with positive tTG and in 81.5% of testnegative patient.Sensitivity and specif icity were 84.8% and 100%,respectively for H pylori infection and,80% and 92.8% for tTG.Twenty-eight patients had positive H pylori antibodies and in all the patients,an active H pylori infection was found.In particular,in 23 out of 28(82%) patients with positive H pylori antibodies,a likely cause of IDA was found because of the active inflammation involving the gastric body.CONCLUSION:Anti-H pylori IgG antibody and tTG IgA antibody testing is able to select women with IDA to submit for gastroscopy to identify H pylori pangastritis and/or celiac disease,likely causes of IDA.

AIM： To evaluate the usefulness of pre-endoscopic serological screening for He//cobacter py/or/ （H py/or/} infection and celiac disease in women aged 〈 50 years affected by iron-deficiency anemia （IDA）. METHODS： One hundred and fifteen women aged 〈 50 years with IDA were tested by human recombinant tissue transglutaminase IgA antibodies （tTG） and anti-H pylori IgG antibodies, tTG and H pylori IgG antibody were assessed using an enzyme-linked immunosorbent assay （ELISA）. All women were invited to undergo upper GI endoscopy. During gastroscopy, biopsies were collected from antrum （n = 3）, gastric body （n = 3） and duodenum （n = 4） in all patients, irrespective of test results. The assessment of gastritis was performed according to the Sydney system and celiac disease was classified by Marsh＇s System. RESULTS： 45.2% women were test-positive： 41 patients positive for H pylori antibodies, 9 patients for tTG and 2 patients for both. The gastroscopy compliance rate of test-positive women was significantly increased with respect to those test- negative （65.4% vs 42.8%; Fisher test P = 0.0239）. The serological results were confirmed by gastroscopy in 100% of those with positive H pylori antibodies, in 50% of those with positive tTG and in 81.5% of test- negative patient. Sensitivity and specificity were 84.8% and 100%, respectively for Hpylori infection and, 80% and 92.8% for tTG. Twenty-eight patients had positive H pylori antibodies and in all the patients, an active Hpylori infection was found. In particular, in 23 out of 28 （82%） patients with positive H pylori antibodies, a likely cause of IDA was found because of the active inflammation involving the gastric body. CONCLUSION： Anti-H pylori IgG antibody and tTG IgA antibody testing is able to select women with IDA to submit for gastroscopy to identify H pylori pangastritis and/or celiac disease, likely causes of IDA.