Menoufia Medical Journal

: 2019  |  Volume : 32  |  Issue : 2  |  Page : 748-

Screening of Helicobacter pylori in patients with alopecia areata

Mahmood D Al-Mendalawi 
 Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Correspondence Address:
Mahmood D Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad Post Office, P.O. Box 55302, Baghdad

How to cite this article:
Al-Mendalawi MD. Screening of Helicobacter pylori in patients with alopecia areata.Menoufia Med J 2019;32:748-748

How to cite this URL:
Al-Mendalawi MD. Screening of Helicobacter pylori in patients with alopecia areata. Menoufia Med J [serial online] 2019 [cited 2019 Nov 23 ];32:748-748
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I have read with interest the case–control study by El-Farargy et al.[1] on the screening of Helicobacter pylori (H. pylori) in Egyptian patients with alopecia areata. The authors found that the values for H. pylori infection were positive in 25 of the 30 (83.3%) patients evaluated, whereas in five (16.7%) patients, the values did not support H. pylori infection. In the control group, seven of 20 (35%) had positive results. There was a highly significant difference between the patients (83.3%) and control (35%) groups regarding positivity of H. pylori stool antigen (HpSAg). In the two groups, HpSAg was found to be significantly elevated with mean ± SD of 1.73 ± 0.88 U/ml for patients and 1.04 ± 0.85 for controls (P = 0.009)[1]. On the basis of these findings, the authors concluded that H. pylori infection might play a role in the pathogenesis of alopecia areata[1]. I presume that such conclusion ought to be cautiously taken. This is based on the following methodological limitation. In the methodology, the authors mentioned that HpSAg were detected using a kit based on enzyme immunoassay for in-vitro qualitative and quantitative detection of H. pylori antigens[1]. It is obvious that in the clinical settings, there are two different methods to detect H. pylori antigen in stool samples, namely, polyclonal enzyme-linked immnunosorbent assay (ELISA) and PCR test. Interestingly, evaluation of these two methods was done in an Egyptian study. It showed that the stool-ELISA test had the sensitivity and positive predictive value of 72.2 and 92.9%, respectively, whereas the stool-PCR test recorded the sensitivity of 72.2% and specificity of 100%[2]. I wonder why the authors referred to stool-ELISA test rather than stool-PCR test in the methodology. I presume that if the authors employed stool-PCR test, different results might be yielded.

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1El-Farargy SM, El-Hamied Yasien HA, El-Mohsen Montaser BA, Rashad H. Screening of Helicobacter pylori in alopecia areata patients. Menoufia Med J 2017; 30:935–939.
2Alam El-Din HM, Hashem AG, Ragab YM, Hussein IL, Mohamed DB, Mohamed el-CB. Evaluation of noninvasive versus invasive techniques for the diagnosis of Helicobacter pylori infection. Appl Immunohistochem Mol Morphol 2013; 21:326–333.