Upper gastrointestinal bleedings in patients with hereditary coagulation disorders in Northwest of Iran

Abstract

Upper gastrointestinal (UGI) bleeding is one of the most life-threatening complications, in up to 25% of persons with hemophilia (PWH). Recurrent bleeding is common and can be caused by the Helicobacter pylori infection. Our aim was to evaluate the role of H. pylori infection in UGI bleeding in PWH. Ninety patients with hereditary bleeding disorders, 30 patients with (group A), and 60 patients without (group B) a history of UGI bleeding episodes were included. The prevalence of H. pylori infection was investigated by stool antigen test, and serum serologic tests including immunoglobulin G and anti-CagA. Among 90 patients (81 men, nine women, mean age 31.30 ± 10.72 years), 66 patients with hemophilia A, 10 patients with hemophilia B, six patients with Von Willebrand disease, five patients with platelet function disorders, and three patients with other factor deficiencies were evaluated. About 46.7% of patients in group A, and 23.3% of patients in group B were anti-CagA-positive (P=0.02), whereas 76.7% of patients in group A and 51.7% of patients in group B had H. pylori immunoglobulin G antibodies (P=0.02). H. pylori antigen in stool was positive in 76.7% in group A and 55% in group B (P=0.03). No statistically significant difference was found between type and severity of diseases and risk of UGI. H. pylori infection should be considered as an important cause of UGI bleeding in PWH. We would recommend stool antigen test as a new and noninvasive screening test for diagnosis of H. pylori infection in all patients with hereditary hemorrhagic disorders.