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Journal of Medical Sciences
Year: 2007  |  Volume: 7  |  Issue: 5  |  Page No.: 716 - 723

Seroprevalence of Helicobacter pylori in Juvenile Rheumatoid Arthritis And its Relation to Disease Severity

Manal E. Kandil, Azza El Hamshary and Nahed A.R. Emara    

Abstract: We aimed to evaluate seroprevalence of Helicobacter pylori (H. pylori) IgG antibodies in children with Juvenile rheumatoid arthritis (JRA) and to assess the effect of its eradication treatment on various symptoms and inflammatory indices, to find out whether there is a possible link between this bacterium and disease severity. This study included 21 children with JRA (10 males and 11 females) with a mean age (10.5±4.5 years). Eighteen healthy children matched in age and sex were used as a control group. All subjects had undergone full clinical examination and laboratory investigations including complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor, anti-nuclear antibodies, serum albumin, α1-globulin, α2-globulin, β-globulin and γ-globulin. H. pylori IgG antibodies detection was done by ELISA technique. We found that 61.9% of patients with JRA were seropositive for H. pylori IgG, whereas only 27.8% of the healthy children were seropositive (p<0.05). Red cell indices and albumin were statistically significantly higher in healthy children than JRA patients (p<0.05). ESR was statistically significantly higher in JRA patients than controls (p<0.05). The number of swollen joints correlated positively with β-globulin, ESR and CRP (r = 0.43, p = 0.048; r = 0.67, p = 0.001 and r = 0.54, p = 0.01, respectively). Comparison between H. pylori seropositive and seronegative JRA patients revealed that ESR and CRP were statistically significantly higher in H. pylori seropositive JRA patients than seronegative patients (p<0.05). Gastrointestinal symptoms were significantly more obvious in the former subgroup (p<0.05). Hemoglobin level, hematocrite and serum albumin were statistically significantly lower in H. pylori seropositive than seronegative JRA patients (p<0.05), while α1-globulin, α2-globulin, β-globulin and γ-globulin showed no significant differences between both subgroups (p>0.05). Six months after starting H. pylori eradication treatment; the clinical parameters of JRA and ESR were statistically significantly lower in H. pylori seropositive JRA patients than the base line values (p<0.05). They showed progressive improvement of all clinical parameters over time. In conclusion: H. pylori seroprevalence is more frequent in JRA patients than healthy children. It might have a role in the pathogenesis of JRA and might be implicated in aggravating severity of symptoms since treatment for its eradication might induce progressive and considerable improvement of both clinical symptoms and laboratory investigations.

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