Association of Helicobacter pylori in nasal polyposis
Keywords:Nasal polyp, Helicobacter pylori, Gastro esophageal reflux disease, Specific and non specific tests
Background: A significant number of patients with gastro esophageal reflux disease (GERD) disease are actually infected with Helicobacter pylori, transmission of the bacteria from stomach to nose may occur. Few studies have revealed the presence of Helicobacter pylori in normal nasal mucosa, in patients with chronic rhino sinusitis and in nasal polyps but the results have been conflicting and further studies are required for its establishment. The aims and objectives of the study were to study the presence of Helicobacter Pylori in nasal polyp specimen by using non specific tests- rapid urease test, Giemsa stain and H&E stain, specific tests-immunohistochemistry and culture.
Methods: 35 patients with nasal polyp were underwent endoscopic nasal polypectomy. Specimens were analyzed for presence of Helicobacter pylori by urease test, Giemsa stain, Hemotoxylin and Eosin stain, Immunohistochemistry and culture.
Results: Out of 35 patients 10 patients had gastro esophageal reflux disease (GERD), in which 06 patients showed positive for urease test and Giemsa stain and 3 patients picked up by immunohistochemistry test and growth in culture media. Of which Helicobacter pylori positive cases by H&E stain showed typical hyperplastic epithelium and lymphoid aggregation.
Conclusions: There exists an association between H. pylori and nasal polyps and GERD. Non-specific urease test and modified Giemsa stain were positive in considerable number of cases, but the statistical significance could not be established. Immunohistochemistry and culture can be regarded as the procedure of choice in truly positive cases infected with H. pylori along with hyperplastic epithelium in H & E stain, all with co-relative finding but require larger study to establish their association which will help in further research and treatment.
Brown LM. H. pylori: Epidemiology and Routes of Transmission. Epidemiol. 2000;22(2):283-97.
Ross Histology Text & Atlas. 6th edition. 577.
Goodman KJ, Correa P. The transmission of H. pylori. A critical review of the evidence. Int J Epidemiol. 1995;24(5):875-8.
Testerman TL, Morris J. An updated view of Helicobacter pylori pathogenesis, diagnosis and treatment. World J Gastroenterol. 2014;20(36):12781-808.
Cammarota G, Tursi A, Montalto M, Papa A, Veneto G, Bernardi S, et al. Role of dental plaque in the transmission of Helicobacter pylori infection. J Clin Gastroenterol. 1996;22(3):174-7.
Li C, Musich PR, Ha T, Ferguson DA Jr, Patel NR, Chi DS et al. High prevalence of Helicobacter pylori in saliva demonstrated by a novel PCR assay. J Clin Pathol. 1995;48(7):662-6.
Unver S, Kubilay U, Sezen OS, Coskuner T. Investigation of Helicobacter pylori colonization in adenotonsillectomy specimens by means of the CLO test. Laryngoscope. 2001;111(12):2183-6.
Mravak-Stipetić M, Gall-Troselj K, Lukac J, Kusić Z, Pavelić K, Pavelić J. Detection of Helicobacter pylori in various oral lesions by nested polymerase chain reaction (PCR). J Oral Pathol Med. 1998;27(1):1-3.
Dzink JL, Tanner AC, Haffajee AD, Socransky SS. Gram negative species associated with active destructive periodontal lesions. J Clin Periodontol. 1985;12(8):648-59.
Madinier IM, Fosse TM, Monteil RA. Oral carriage of Helicobacter pylori: a review. J Periodontol. 1997;68(1):2-6.
Goodman KJ, Correa P. The transmission of Helicobacter pylori. A critical review of the evidence. Int J Epidemiol. 1995;24(5):875-8.
Laine L, Lewin D, Naritoku W, Estrada R, Cohen H. Prospective comparison of commercially available rapid urease tests for the diagnosis of Helicobacter pylori. Gastrointest Endosc. 1996;44(5):523-6.
El-Zimaity HM, Graham DY, al-Assi MT, Malaty H, Karttunen TJ, Graham DP et al. Interobserver variation in the histopathological assessment of Helicobacter pylori gastritis. Hum Pathol. 1996;27(1):35-41.
Cutler AF, Havstad S, Ma CK, Blaser MJ, Perez-Perez GI, Schubert TT. Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection. Gastroenterology. 1995;109(1):136-41.
Gzyl A, Dzierzanowska D, Rozynek E, Celińska-Cedro D, Dura W, Berg DE. PCR-based diagnosis of Helicobacter pylori infection in Polish children and adults. J Med Microbiol. 1999;48(4):349-56.
Ashton-Key M, Diss TC, Isaacson PG. Detection of Helicobacter pylori in gastric biopsy and resection specimens. J Clin Pathol. 1996;49(2):107-11.
Cvorovic L, Brajovic D, Strbac M, Milutinovic Z, Cvorovic V. Detection of Helicobacter pylori in nasal polyps: preliminary report. J Otolaryngol Head Neck Surg. 2008;37(2):192-5.
Bansal D, Sharma S, Agarwal S, Saha R, Gupta N. Detection of Helicobacter pylori in Nasal Polyps. Head Neck Pathol. 2016;10(3):306-13.
Ozcan C, Polat A, Otağ F, Görür K. Does H. pylori play a role in etiology of nasal polyposis? Auris Nasus Larynx. 2009;36(4):427-430.
Al-Abbasi AM, Jasim AH. Association of H. pylori and Nasal Polyposis. Iraqi Postgraduate Med J. 2012;11(1):92-6.
Koc C, Arikan OK, Atasoy P, Aksoy A. Prevalence of H. pylori in patients with nasal polyps: a preliminary report. Laryngoscope. 2004;114(11):1941-2.
Nemati S, mojtanedi A, Naghari SE, Banan R, Zia F. Investigating H. pylori in nasal polyposis using Polymerse chain reaction, urease test and culture. Eur Arch Otorhinolaryngol. 2012;269(5):1457-61.