A Clinical Significance of Helicobacter Pylori Infection in Hemophilic Children with Gastrointestinal Hemorrhage.

Abstract

Abstract 4442 PurposeFor hemophiliacs gastrointestinal hemorrhage is a life-threatening complication and can be caused by the Helicobacter pylori infection. In this study, the prevalence of H. pylori infection among child hemophiliacs with gastrointestinal hemorrhage and the recurrence rate after eradication H. pylori treatment was investigated. Patients and MethodsSeven children with hemophilia A with hematemesis (age, 5.3∼17.0 year) were evaluated for the causes of gastrointestinal hemorrhage and the detection of H. pylori. Gastroendoscopy was done to find the bleeding focus and for further evaluation including rapid urease test and mucosal biopsy.Result: Four patients had dyspepsia and abdominal pain for several weeks or months prior to hematemesis. Three patients did not show any signs of bleeding. From gastroendoscopy, four patients were diagnosed as duodenal ulcer, one as H. pylori associated chronic gastritis and one as hemorrhagic gastritis. One patient showing a normal finding was diagnosed with adenoid hemorrhage after nasopharyngoscopy. H. pylori infection was found in four of six patients with GI bleeding (3, duodenal ulcer; 1, H. pylori associated chronic gastritis). The patients with H. pylori infection had an eradication treatment of triple therapy and no recurrence happened. ConclusionIn child hemophiliacs, H. pylori should also be considered as an important cause of gastrointestinal hemorrhage. The recurrence of the infection and gastrointestinal hemorrhage can be prevented with eradication of H. pylori. Screening test for H. pylori would be needed in child hemophiliacs in endemic area.Table 1The characteristics of hemophiliac children and the study results of upper gastroendoscopy, UBT, CLO and biopsyNo.Age (years)Disease severity of hemophiliaPrevious GI symptomBP (mmHg)HR (/min)Hb (g/dL)Upper gastroendoscopyUBTCLOBiopsyP117.6severeabdominal pain for 2 years100/60928.0duodenal ulcerNApositiveH. pyrotiP215.1moderatenone85/401106.1duodenal ulcerNApositiveH. pyrotiP310.3moderatenone103/691357.6duodenal ulcerNApositiveH. pyrotiP413.8moderateabdominal pain for 1 month110/601205.0gastritis with nodularitypositiveNANAP5*5.3moderatenone70/401307.2normalNANANAP611.8mildabdominal pain for 2 weeks120/601075.9hemorrhagic gastritisnegativeNANAP712.5moderateabdominal pain for 2 weeks100/461205.0duldenal ulcernegativeNANABP, blood pressure; HR, heart rate; Hb, hemoglobin; UBT, 13C urea breath test; CLO, rapid urease test; NA, not analyzed*Adenoid bleeding Disclosures:No relevant conflicts of interest to declare.