Absence of Helicobacter pylori in Pediatric Adenoid Hyperplasia

Objectives: To (1) develop a reverse transcriptionpolymerase 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 Helicobacteraceaespecific 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.