The contribution of specific immunoglobulin M antibodies to the diagnosis of Helicobacter pylori infection in children

OBJECTIVE:To evaluate the diagnostic value of specific immunoglobulins G and M in the detection of Helicobacter pylori infection. METHODS:Sera from 68 H. pylori-infected children and 35 H. pylori-negative children (aged 1–15 years) were examined using recent-generation serum enzyme-linked immunosorbent assay (ELISA) tests (Malakit Helicobacter pylori series; Biolab, Limal, Belgium). RESULTS:All of the investigated children had positive values for immunoglobulin G antibodies. However, anti-H. pylori-specific immunoglobulin M could be detected only in 19 (27.9%) of the 68 children. When compared with the C-urea breath test, these findings represent sensitivity, specificity and positive and negative predictive values of 27.9, 100, 100 and 41.7%, respectively, for the serum ELISA test for the detection of H. pylori-specific immunoglobulin M compared with 100.0, 97.2, 98.5 and 100.0% respectively, for the Malakit for the the detection of specific immunoglobulin G antibodies. CONCLUSION:Although H. pylori-specific immunoglobulin G has been established as a reliable indicator of active H. pylori infection, using the Malakit for the detection of H. pylori-specific immunoglobulin M does not seem to be of major value in the diagnosis of H. pylori infection in children.European Journal of Gastroenterology & Hepatology 1995, 7:979–983