Helicobacter pylori infection in elderly people: does quantitative serological testing predict gastroduodenal ulcer disease?

Invasive diagnosis of peptic ulcer disease in the aged often carries an increased risk. Recently a correlation between high IgG serum antibody concentrations against H. pylori and a clinical diagnosis has been reported. In this study, we attempted to establish a relationship between the magnitude of serum IgG antibody to H. pylori and the endoscopic diagnoses in H. pylori-infected elderly patients. All the patients aged 60 or older were entered into the study prospectively. Those patients who had ulcerogenic medications or H. pylori eradication therapy prior to testing, or who were seronegative for H. pylori were excluded. Endoscopic diagnoses included duodenal ulcer, gastric ulcer, presence of both gastric ulcer and duodenal ulcer, gastroduodenal erosions, and nonulcer dyspepsia. H. pylori IgG serology was determined by an enzyme-linked immunosorbent assay with values of greater than 50 units/ml being seropositive. In all, 182 seropositive elderly patients were recruited. The age was 68.8+/-6.7 (mean+/-SD) years (range = 60-94 years). The serum IgG titers ranged from 51 units/ml to 800 units/ml with a peak frequency at 50-99 units/ml (30.8%). The quantitation of H. pylori IgG values and the endoscopic diagnoses failed to demonstrate any relationship of statistical significance. Our results indicate that the magnitude of H. pyloni IgG serology cannot be used to predict the presence or absence of peptic ulcer disease in the elderly.