Absence of Helicobacter pylori in pediatric adenoid hyperplasia.

OBJECTIVES

To (1) develop a reverse transcription-polymerase chain reaction assay to determine whether Helicobacter pylori and/or other members of the Helicobacteraceae family are detected in hyperplastic adenoids of children and (2) critically analyze published polymerase chain reaction methods to ascertain whether false-positive detection of H pylori has been reported.

DESIGN

Cohort study.

PATIENTS

Adenoid biopsy specimens (78 hyperplastic and 15 normal) were collected from children aged 2 to 10 years.

METHODS

Total RNA was extracted before reverse transcription of bacterial RNA using Helicobacteraceae-specific primer. A nested reverse transcription-polymerase chain reaction protocol was designed to detect all species of the Helicobacteraceae family. A piece of each biopsy specimen was examined histologically.

RESULTS

Laryngopharyngeal reflux was suspected in 41% of the children (n = 23) on the basis of the Reflux Symptom Index. No evidence of H pylori was found in any adenoid sample. Candidatus Wolinella africanus was the only Helicobacteraceae family member detected in 1 hyperplastic adenoid. Histologic examination identified very few bacterial organisms. Previous polymerase chain reaction findings may be the result of false-positive H pylori detection.

CONCLUSIONS

Inflammation and enlargement of the adenoids is not likely due to ongoing bacterial infection arising from laryngopharyngeal reflux. We conclude that H pylori and other Helicobacteraceae family members are not major contributors to the development of hyperplastic adenoids in children.