Upper Gastrointestinal Bleeding In Patients with Haemophilia In Iran: Prevalence of Helicobacter Pylori Infection.

Upper Gastro Intestinal (UGI) Bleeding is one of the most life-threatening complications, and occurs in up to 25% of persons with Hemophilia (PWH).Recurrent bleeding is common and can be caused by the Helicobacter Pylori (H.Pylori) infection. Our aim was to evaluate the role of H.Pylori infection in UGI bleeding in PWH, using Serology and Stool antigen tests.

Ninety patients with hereditary bleeding disorders, 30 patients(group A) with and 60 patients(group B) without a history of UGI bleeding, who were admitted to our Hemophilia Treatment Center, were included in the study. The prevalence of H.Pylori infection was investigated by stool antigen test, as well as serum serologic tests including IgG and anti-CagA.

Among 90 patients (81 men,16 women, mean age 31 ± 11 years), 66 patients with Hemophilia A,10 patients with Hemophilia B, 6 patients with VWD, and 3 patients with other factor deficiencies were evaluated for H.Pylori infection. About 46.7% of patients in group A, and 23.3% of patients in group B were anti-Cag A – positive in serum (P=0.02), while 76.7% of patients in group A and 51.7% of patients in group B had H.Pylori IgG antibodies in serum (P= 0.02). H.Pylori antigen in stool was positive in 76.7% in group A and 55% in group B (P=0.03). Gastro endoscopy was done to find the bleeding focus and further evaluations, in 19 patients with acute UGI bleeding. No statistically significant difference was found between type and severity of diseases and risk of UGI.

There was a statistically significant differences in H.Pylori infection between patients with and without UGI bleeding history. So, 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 none-invasive screening test for diagnosis of H.Pylori infection in all patients with hereditary hemorrhagic disorders.

Dolatkhah:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Employment, Research Funding. Khoshbaten:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Research Funding. Kermani:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Employment, Membership on an entity's Board of Directors or advisory committees, Research Funding. Sanaat:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Employment, Research Funding. Bonyadi:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Employment, Research Funding. Ghojazadeh:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Employment, Research Funding. Kermani:Hematology and Oncology Research Center, Tabriz University of Medical Sciences: Research Funding.