?????? ?????? (?????? ?????????????) Helicobacter Pylori (H.Pylori)

1
?????? ?????? (?????? ?????????????)Helicobacte
r Pylori (H.Pylori)

• LECTURE
• ON
• Helicobacter Pylori
• By
• DR. ISLAM SABRY KANDEL
• (M.B., B. Ch.)
• MASTER DEGREE IN
• CLINICAL AND CHEMICAL PATHOLOGY
• Faculty of Medicine
• Cairo University

2
?????? (??????? ??????)

• ?????-???? ??????? ?????? ???? ??? ???? ????
  ???????? ???????? ???? ????? ??????? ????? ??????
  ???????? ??? ??? ??? ????? ????? ?? ?????.
• ??? ?????? ?? ??????? ??????....
• ??? ?????....
• ??????.

3
?? ??? ????? ??? ??? ???? ???? (??? ???? ????
????)- ?????? ??? ?????? ??????? ????? ??????
???? ??? ?????? ???? ?????? ?????? ????? ????
?????? ???? ?????? ?????? .
4
????? ??????

• ?????? ?? ??? ????? ????? ????? ?????? ???????
  ???? ???? ???? ?? ??????? ???? ???????? ???????
  ???? ????? ???? ?? ????? ????? ???? ?????? ??????
  ??? ????? ???????.
• ????? ??????? ??????? ?? ?????? ????????? ???????
  ???????? ? 12.
• ?????25?? ??????12?? ??????? 1300?? ?????? ??
  ??????? ??????? ???? ?? 4 ????? ????? ??? ??????.
• (??? ???? ???? ???? ?? ??) ???? ??????????88

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?????? ?????? ( H.Pylori )
6
??? ?????? ?????? ??????-

• ?????? ??????( H.Pylori )?? ???? ???? ????? ??
  ?????2-4 ?????? ?????? 1 ??????(Grame negative
  spiral shaped Urease producing bacterium)

7
???????? ???????????????
8
?????? ????????

• ??????? ???????? ??????????? (???? ?????? ? ?????
  ?????) ??? 1983? ??? ???? ???????? ????? ???? ??
  ???? ??? ????? ?? ??? ???????? ?????.

9
?????? ?????? ??????
-((Epidemiology ???? ???? ??????)???? ?? 90 ??
???????? ?? ??????? ???????) ?????? ???? ????????
10
??????

• ???? ?????? ?? ???? ??? ?????? ??????? ?????????
  ?? ????? ???????? ???????? ????? ?????? ?????.

11
????? ????? ?????? ????????

• ???? ????? ???????? ??? ????? ????? ??? ??????
  ??? ??? ???-1 -???????.
• 2-????? ?????? ?????.
• 3-??????? ?????? ?????????? ???????.
• 3-?????? ?????? ??????.

12
????? ?????? ?? ???? ??????

• 1- ???? ?????? ?????? ????? ????????Urease ?????
  ???? ?????? ???? ??????? ??? ?????? ??????????
  ??? ???? ????? ???? ??? ??????? ???? ???? ?????
  ????? ??????? ?????? ??? ????? ??.
• -2- It possesses a proton pump.

13
?????? ??????
14
???? ????? ?????? ????????!

• ???? ?????? ?????? ?? ??????? ???????? ?????
  ?????? ????? ???????? ??????? ??????? ??????
  ???????(???? ??????) ???????? ?????? ??? ????????.

15
????????!

• ??? ?????? ?????? ?????? ?? ??????? ???????? ????
  ???? ??????? ???????? ???? ???????? ??????
  ??????? ?? ??????? ?????????(Neutrophils)
  ???????? ??????? (Eosinophils)????????
  ????????(Basophils) ??? ???? ?????????? ???????
  ?? ???? ??????.

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??? ????? ?????? ??????

• 1-????? ?????? ??? ???? ?????.
• 2-??? ????? ????? ?? ????? ???? ?????.
• 3-?????? ?????? ?????? ?????? ????? ?????.
• 4-????? ?????? ???????? ????? ???? ??? ????
  ???????.

17
????? ?????? ??????

• ???? ???? ???????? ???? ?????? ???????? ??????
  ?????? ?? ?????? ??????? ???? ???? ????? ???????
  ?????? ??????? ??? ?????? ?? ?????? ????? ???????
  ?? ??? ????????????? ????? ??????.

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??? ???? ???????

• ???? ?????? ?????? ?????? ??? ?????? ???? ????
  ?????? ???
• 1-VacA (Vacuolating toxin)
• 2-Cag A(Cytotoxic associated protein)

19
???? ??????
20
???? ?????? ???
21
??????? ??? ???????? ????????!

• ?? ????? ?????? ?????? ?????? ????? ?????
  ???????? ?? ??? 1994? ???? ????? ????? ??????.
• ????? ?????? ???? ??? ???????? ??????? ??????
  ??? 1-Gastric adenocarcinoma
• 2-Gastric B cell Lymphoma

22
????????
23
???? ?????? ?????? ??????
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????????

• Diagnosis of Helicobacter Pylori Infection
• A- Invasive Methods (Endoscopy)-
• ??? ?????-????????-???????
• 1-Rapid Urease Test-
• 2-Culture-
• 3-Histology-

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• Invasive Methods
• (Endoscopy)

• 1- ?? ??? ????? ??? ??? ???? ?? ?????? ????????
  ?????? ????? ?? ???????? .
• 2-???? ???????? ???????? ???? ?????93-95.
• 3-???? ??????? ??? ?? ???? ?????? ?? ?????? ??
  ??????? ???? ?? ????? ??? ????? ?????? ????? ???
  ?? ????? ???? ????? ??? ??????? ?????? ??? ????
  ????? ???? ????? ?? ???????? .
• -

26
?????? ???????? ?????? Rapid Urease Test

• ???? ?????? ???????? ?? ?????? ???????? ?? ?????
  ???????? ??????? ??? ??????? ?????? .
• 2-?? ???? ???? ???????? ????? ???? ???????? ??
  ??????? ?????? ????????(Urease) ?????? ???? ?????
  ???????? ?????? ???? ????(100 ??? ?? ?????? ????)
  ?????? ???????? ????? ??? ??????? ??????.

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????? ??????? ??????? ?????? Culture
Sensitivity Test
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??? ????? ?????? ??? ??? ???? ???????? Histology
29
????????

• Diagnosis of Helicobacter Pylori Infection
• B-Non Invasive Methods
• (Serological tests)-?????????? ??????? 1-
• Stool Test ))?????? ?????? ?????? ??????? 2-
  

(Urea breath test)?????? ?????? ?????? ??????
3-
30
?????????? ??????? ??????

• ????? ??? ?????????? ?? ?????? ??????? ????
  ?????? ???? ?????? ??????? ?????? ????? ????????
  ??? ??? ?????? ?? ?????? ????? ?? ???? ???????
  ??????? ???????? ??? ?????? ?????? ??????
  ??????(Rapid H. Pylori) ?? ?????? ????
  ????????(ELISA).

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?????? ?????? ?????? ?????? ?????? Stool Test For
H.Pylori

• ?????? ????? ????(Qualitative Immunoassay)
• ????? ?? ???????? ?? ?????? (???????? ???????? ??
  90-95) ??????? ?????? ??????? ???????? ??????.
• ???? ????????-
• 1-??? ??? ???????(12 ????).
• 2-?????? ??? ????? ???????.
• 3-???? ???? ??????? (?? 48 ???? -72????).

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?????? ???????? ?????? ( Urea Breath Test )

• ??? ???? ????? ???????? ???? ?????? ??????
  ??????? ??????? ?????? ????? ????? ??????? ??
  ?????? ?????? ?????? (???????? ???????? ???????
  ?? 98-100).
• ?????? ???? ???????-
• 1-??? ??? ??????? (20 ?????) ????? ???? ???????
  (5 ?????).
• 2- ??? ?????? ??? ????? ??????? (??? ??????? ???
  ???? ????? ??????).
• 4- ?????? ???? ?? ??????? ??????? ?????????
  ?????? ? ??? ???? ???????? ??? ????? ??? ???? ??
  ?? ? ???? ?????? ? ???? ?????? ??? ?????? ?

33
?????? ???????? ?????? ( Urea Breath Test )

• ????? ???????? ?????? ??????? ????? ?????
  ?????????? ????? ???? ???????? ?????? ??????
  ?????? ????? ??? (????? urea) ?? 50 ?? ???.

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?????? ???????? ?????? ( Urea Breath Test )

• ??? ???? ???? ???????? ???? ???????? ?????? ?????
  (Urease) ????? ???? ?????? ??????? ???urea ?????
  ??????? ????? ((C13 ?? ???? ???????.

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?????? ???????? ?????? ( Urea Breath Test )

• ??? ??? ????? ???? ?????? ?????? ?? ??? ??? ????
  ??? ?????.

36
?????? ???????? ?????? ( Urea Breath Test )

• ????? ??? ??????? ?????? ????? ?????? ???????
  ????? ??? ????? ?? ???? ???? ??? ???? Mass
  Spectrometer ?????? ?? ???? ???????? ? ??????
  ?????? ???? ?????.

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???? ?????? ????? Urea Breath Test

• 1-??? ?? ???? ?????? ?????? ???? ???? ?????.
• 2-?????? ???? 1-2 ????? ?? ??? ???????? ???????
  (???? ????? ????????) ??????? ??????? ?? ??????
  ?????? ????? ???????? ( (ppi???
  Lansoprazol, Omeprazole

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???? ?????? ?????? ?????? ?? ???? ?????

• 1-????? ??????? ??? ???? ???? ???????????
  ???????? ???? ?? ??? ???? ??????? ??????? ????
  ??????? ?????? ?????? ???? ?????? .
• 2-?????? ??? ??? ???????? ??? ??? 3 ?????.

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?????? Treatment

• ????? ?????? (??? ???? ???? ????) ???????? ????
  ?????? ???? ???? ??? ???? ?? ???? ??? ??? ??? ??
  ???? ??? ?????.

40
?????? ???????

? ???? ?? ????? ??????? ???? ??? ?????? (???
?????? ?? ????? ???????? ??? ????? ????????? ?
??? ??? ?????? ?????? ??????? ?????? ??? ??? ???
?????).
41
???? ?????? ?????? Treatment

• ??? ???? ?????? ?????? ????????? ??????? ????
  10-14 ????? ? ???????? ??????? ??????? ??????
  ????? ??????? ???? ?????? ??????? ??? ????? ?????
  ??? ??? ?????? ?? ??????? ???? ????? ????? ?????
  ????? ?????? ??? ???????? ???? ?? 95.

42
????? ??????

• ?? ???? ???? ???? ?????? ? ?????? ??? ??? ??????
  ????? ??? ??? ?? 5 ????? ???? ?????? ?? ??????
  ??????? ?????? ??????.
• ????? ??????? ?? ???? ????? ????? ????? ????
  ????? ???? ??? ?????? ???? ??? ????? ???????
  ???????? ?????? ??????? ?????????? ??????? ????
  ?? ?????? ??????? ????????? ??? ??????? ??
  ???????.

43
???????!
44
?? ????? ?????? ????? ???? ??????? ???????
??????? ?????
45
(No Transcript)
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(No Transcript)