1. Comparative evaluation of conventional methods and Elisa based IgG antibodies detection for diagnosis of helicobacter pylori infection in cases of dyspepsia Arora u.et al, Indian Journal of Medical Microbiology Year : 2003 | Volume : 21 | Issue : 1

2. INTRODUCTION   Helicobacter pylori is a gram negative,spiral flagellated bacterium that colonizes the human stomach. .  Presently, its role has been established in chronic antral gastritis, duodenal ulcer, chronic gastric ulcer, dyspepsia, gastric cancer and gastric lymphoma.  World Health Organization added H.pylori to its list of known carcinogens.

3.   The diagnosis of H.pylori infection is currently based upon endoscopic biopsy based invasive tests (Rapid urease, culture, Gram staining and histopathology)   Non invasive, serology based tests detecting IgG antibodies (since H.pylori causes chronic infection) are commercially available. INTRODUCTION

4. INTRODUCTION   AS invasive procedures are tedious hence every person complaining of symptoms suggestive of gastroduodenal disease cannot be subjected to these tests   The present study was therefore planned for comparative evaluation of conventional methods and ELISA based IgG antibody detection by a commercially available kit for diagnosis of H.pylori infection in cases of dyspepsia

5.   Subjects: 75 dyspeptic patients   Specimen: Gastric biopsy specimen Serum samples   Tests procedures : Biopsy specimens were processed for rapid urease test, gram staining and culture. Serum samples were used for detecting IgG antibodies against 128kDa external protein (Cag A) of H.pylori using a commercially available ELISA kit. Materials and Methods

6. Results Type of Test Patients ( n = 75 ) Positive Percentage Rapid urease test : 54 72% Gram staining 15 20% Culture 21 28% Significant IgG titres (20U/ml) 57 76%

7.   The difficulties associated with invasive test and low isolation rate of this organism has led to the development of various serological test   Results of positive serology also comparable with biopsy based RUT which at present is most commonly used test for diagnosis of H.pylori infection Discussion

8. Discussion   No case was detected in which rapid urease test was positive but serology insignificant.   Three cases were negative by rapid urease test, but had significant IgG levels. This may be due to……

9. Conclusion   We recommend serology as a screening procedure only and if the titres are insignificant, the role of endoscopy just to make a diagnosis of H.pylori infection in dyspeptic patients is not warranted.