Abstract
BackgroundThe aim of this study was to investigate the relationship between prior Anisakis infections and upper gastrointestinal bleeding (UGIB), and its interaction with non-steroidal anti-inflammatory drug (NSAID) intake.Methods/Principal FindingsWe conducted a hospital-based case-control study covering 215 UGIB cases and 650 controls. Odds ratios (ORs) with their confidence intervals (95% CIs) were calculated, as well as the ratio of the combined effects to the sum of the separate effects of Anisakis allergic sensitization and NSAIDs intake. Prior Anisakis infections were revealed by the presence of anti-Anisakis IgE antibodies specific to the recombinant Ani s 1 and Ani s 7 allergens used as the targets in indirect ELISA. Prior Anisakis infections (OR 1.74 [95% CI: 1.10 to 2.75]) and the intake of NSAIDs (OR 6.63 [95% CI: 4.21 to 10.43]) increased the risk of bleeding. Simultaneous NSAIDs intake and Anisakis allergic sensitization increased the risk of UGIB 14-fold (OR = 14.46 [95% CI: 6.08 to 34.40]). This interaction was additive, with a synergistic index of 3.01 (95% CI: 1.18–7.71).ConclusionsPrior Anisakis infection is an independent risk factor for UGIB, and the joint effect with NSAIDs is 3 times higher than the sum of their individual effects.
Highlights
Upper gastrointestinal bleeding (UGIB) is a relatively frequent and potentially lethal multicausal medical emergency [1]
Gastric and duodenal ulcers are a major cause of upper gastrointestinal bleeding (UGIB), and bleeding from these lesions is frequently related to intake of non-steroidal anti-inflammatory drugs (NSAIDs) [2]
We report the results of a case–control study, which sought to determine the risk of UGIB associated with prior Anisakis simplex infections and any potential interaction with NSAID intake
Summary
Upper gastrointestinal bleeding (UGIB) is a relatively frequent and potentially lethal multicausal medical emergency [1]. Gastric and duodenal ulcers are a major cause of UGIB, and bleeding from these lesions is frequently related to intake of non-steroidal anti-inflammatory drugs (NSAIDs) [2]. Depending on the site of infection and the predominant clinical symptoms, acute infections by Anisakis can be classified as gastric anisakiasis, gastro-allergic anisakiasis, and intestinal anisakiasis. Recent evidence from seroepidemiologic studies undertaken in Spain indicates that the great majority of human cases of anisakiasis are asymptomatic, and that the prevalence of disease in different Spanish regions may range from a minimum of 0.4% [5] to more than 10% of the population [15,16]. The aim of this study was to investigate the relationship between prior Anisakis infections and upper gastrointestinal bleeding (UGIB), and its interaction with non-steroidal anti-inflammatory drug (NSAID) intake
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
