HELICOBACTER PYLORI PREVALENCE AND HISTOPATHOLOGICAL FINDINGS IN DYSPEPTIC PATIENTS

Authors

  • Khalid Mehmood
  • Abdul Aleem Awan
  • Naveed Muhammad
  • Fariha Hasan
  • Abdul Nadir

Abstract

Background: Helicobacter pylori (H. pylori) colonizes in half of the population of developed and nearly all inhabitants of developing countries. The infection is characterized by gastritis but can present more complicated disease states. We intended to report prevalence of H. pylori infection by histopathology and presence of gastritis, activity, atrophy and intestinal metaplasia in dyspeptic patients of Islamabad, Pakistan. Methods: Ninety four patients identified to be dyspeptic on the basis of Rome-III criteria were included in the study and diagnosed for H. pylori status by Histopathology. The grading and severity of gastritis was documented as nil, mild, moderate or severe, based on the Sydney system. Activity was recorded as present when an increase in the number of neutrophils was observed. Atrophic changes and intestinal metaplasia were also determined. Results: Eighty three out of total 94 (88.3%) patients were positive for H. pylori on histopathology. Out of total 94 patients, chronic gastritis was observed in 89 (94.6%), evidence of activity was found in 37 (39.4%), atrophic changes were observed in 66 (70%) and intestinal metaplasia was present in 4 (4.3%) patients. Conclusion: H. pylori infection in dyspeptic patients of Islamabad appears to be more related with gastritis.Keywords: Helicobacter pylori, Histopathology, Dyspepsia, Gastritis, Pakistan

References

Atherton JC, Blaser MJ. Coadaptation of Helicobacter pylori and humans: ancient history, modern implications. J Clin Invest 2009;119(9):2475–87.

Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006;19(3):449–90.

Hassan SR, Abbas Z: Presence of Helicobacter pylori in dyspeptic patients with endoscopically normal stomach. Pak J Med Sci 2007;23(3):335–9

Nizami SQ, Bhutta ZA, Weaver L, Preston T. Helicobacter pylori colonization in infants in a peri-urban community in Karachi, Pakistan. J Pediatr Gastroenterol Nutr 2005;41(2):191–4.

Abbas Z, Jafri W, Khan AH, Shah MA. Prevalence of Helicobacter pylori antibodies in endoscopy personnel and non-medical volunteers of Karachi. J Pak Med Assoc 1998;48(7):201–3.

Ahmad T, Sohail K, Rizwan M, Mukhtar M, Bilal R, Khanum A. Prevalence of Helicobacter pylori pathogenicity-associated cagA and vacA genotypes among Pakistani dyspeptic patients. FEMS Immunol Med Microbiol 2009;55(1):34–8.

Mehmood K, Hameed Z, Shoukat S, Hasan F, Alam AY, Hameed A, Nadir A. Predictors of depression in patients presenting with dyspeptic symptoms in a GI clinic. J Ayub Med Coll Abbottabad 2011;23(4):49–52

Rotimi O, Cairns A, Gray S, Moayyedi P, Dixon MF. Histological identification of Helicobacter pylori: comparison of staining methods. J Clin Pathol 2000;53(10):756–9.

Mehmood K, Nadir A, Hasan F. Lower education status predicts higher seropositivity for Helicobacter pylori infection in Pakistan. Annual Research & Review in Biology 2014;4(24):3734–41

Price AB. The Sydney system: histological division. J Gastroenterol Hepatol 1991;6(3):209–22.

IARC. Infection with Helicobacter pylori. IARC Monogr Eval Carcinog Risks Hum 1994;61:177–240.

Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001;345(11):784–9.

Kuipers EJ. Review article: Relationship between Helicobacter pylori, atrophic gastritis and gastric cancer. Aliment Pharmacol Ther 1998;12(1 Suppl):25–36.

Megraud F. How should Helicobacter pylori infection be diagnosed? Gastroenterology 1997;113(6 Suppl):93–8.

Galbán E, Arús E, Periles U. Endoscopic findings and associated risk factors in primary health care settings in Havana, Cuba. MEDICC Rev 2012;14(1):30–7.

Ekesbo R, Toth E, Fork FT, Held M, Nilsson I, Wadstrom T et al. K. Chronic Helicobacter pylori infection in a population in southern Sweden analysed by histopathology, immunoblot and ELISA serology. Eur J Gastroenterol Hepatol 2006;18(6):589–3.

Zhang C, Yamada N, Wu YL, Wen M, Matsuhisa T, Matsukura N. Comparison of Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients. World J Gastroenterol 2005;11(7):976–81.

Parsonnet J, Friedman GD, Orentreich N, Vogelman H. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut 1997;40(3):297–301.

Tummuru MK, Cover TL, Blaser MJ. Cloning and expression of a high-molecular-mass major antigen of Helicobacter pylori: evidence of linkage to cytotoxin production. Infect Immun 1993;61(5):1799–809.

Covacci A, Censini S, Bugnoli M, Petracca R, Burroni D, Macchia G et al. Molecular characterization of the 128-kDa immunodominant antigen of Helicobacter pylori associated with cytotoxicity and duodenal ulcer. Proc Natl Acad Sci U S A 1993;90(12):5791–5.

Yang H, Wu SV, Pichuantes S, Song M, Wang J, Zhou D,et al. High prevalence of cagA-positive strains in Helicobacter pylori-infected, healthy, young Chinese adults. J Gastroenterol Hepatol 1999;14(5):476–80.

Ito Y, Azuma T, Ito S, Miyaji H, Hirai M, Yamazaki Y,et al. Analysis and typing of the vacA gene from cagA-positive strains of Helicobacter pylori isolated in Japan. J Clin Microbiol 1997;35(7):1710–4.

Wang JT, Chang CS, Lee CZ, Yang JC, Lin JT, Wang TH. Antibody to a Helicobacter pylori species specific antigen in patients with adenocarcinoma of the stomach. Biochem Biophys Res Commun 1998;244(2):360–3

Mehmood, K, Hasan F. Construction and use of a prokaryotic expression system for Helicobacter pylori AhpC. BMC Research Notes 2012;5:328.

Huang CH, Chuang MH, Lo WL, Wu MS, Wu YH, Wu DC et al. Alkylhydroperoxide reductase of Helicobacter pylori as a biomarker for gastric patients with different pathological manifestations. Biochimie 2011;93(7):1115–23.

Downloads

Published

2014-06-01