[Histonet] H.pylori immunos on gastric biopsies

[Marshall Terry Dr, Consultant Histopathologist]

H. pylori is a pathogen. It does not sit in the stomach behaving itself. Its presence is an indication for treatment, but its absence is *not* an indication for treatment directed against it, irrespective of how inflamed the stomach looks.
The best histologic determinant of H. pylori is an immunostain.
However, in most cases, this is all rather academic, as a quick stool test is available, directed against H. pylori antigen, so in most cases, we are really trying to determine something better done by other means. 

Dr Terry L Marshall, B.A.(Law), M.B.,Ch.B.,F.R.C.Path
 Consultant Pathologist
 Rotherham General Hospital
 South Yorkshire
 England
        terry.marshall <@t> rothgen.nhs.uk

-----Original Message-----
From: Smith, Jeffery D. (HSC) [mailto:Jeffery-Smith <@t> ouhsc.edu]
Sent: 24 January 2006 16:18
To: Bill Blank; Histonet <@t> lists.utsouthwestern.edu
Subject: RE: [Histonet] H.pylori immunos on gastric biopsies


I have to somewhat agree.  Immunos for H. pylori seems to be overkill.  We routinely stain for H. pylori using a Giemsa on all GI biopsies.

________________________________

From: histonet-bounces <@t> lists.utsouthwestern.edu on behalf of Bill Blank
Sent: Tue 1/24/2006 9:29 AM
To: histonet <@t> pathology.swmed.edu
Subject: RE: [Histonet] H.pylori immunos on gastric biopsies



IMO, we take this detecting H. pylori thing too seriously. A rational
physician treats the patient and not any lab test. If I had symptoms
of H. pylori, if my stomach looked inflamed, I would want to be
treated for H. pylori irregardless of their presence on a biopsy.
(Well, maybe as there is some evidence that treating antral H. pylori
may increase the risk of GE junction adenocarcinoma)

I consider immunos on gastric biopsies to be overkill and a waste of
health care dollars.

BIll

At 7:53 AM -0600 1/24/06, GUTIERREZ, JUAN wrote:
>We do immunos on all gastric biopsies.  We had some cases that looked
>negative by giemsa stain, yet the clinical hx suggested otherwise.  When
>we ran the immunos on these so called negatives, we were shocked to see
>the amount of organisms we had missed.  Do you want to take that chance?
>I always ask myself: what if this was my biopsy?  Something to think
>about.

--
_____________________________
Bill Blank
http://kernunnos.com (Celtic studies and numismatics)
OBOD's Message board: http://www.druidry.org/board




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