Conflicting results of non-invasive methods for detection of Helicobacter pylori infection in children with celiac disease - a preliminary study

Background: There are no data addressing the usefulness of non-invasive tests for the detection of Helicobacter pylori (HP) infection in celiac disease (CD). Aim: The aim of this study was to compare two most sensitive and specific tests - urea breath test (UBT) and fecal antigen test (FAT) in HP diagnosis in CD patients. Materials and Methods: The study comprised of 76 CD patients, 49 healthy subjects (HS) and 35 patients who underwent differential diagnosis due to abdominal pain (AP patients). The presence of HP infection was evaluated using the 13C isotope-labeled UBT and FAT (ELISA). Results: HP infection was diagnosed based on UBT and FAT in 8 (16.3%) and 7 (14.3%) HS, and in 8 (10.5%) CD patients and 12 (34.3%) AP patients, respectively, using both tests. The prevalence of conflicting results in comparison with positive results (obtained with any of the two tests) was distinctly higher (54.5%) in CD group than in other subjects (23.3%); however, due to low HP prevalence, it did not reach the level of significance (p<0.1759). Conclusion: CD may increase the risk of divergent results of non-invasive tests used for the detection of HP infection in children. Since UBT is the most reliable test, we suggest its standard use as a method of choice in pediatric CD - at least until new evidence emerges supporting a different approach.