Risk of gastrointestinal bleeding associated with Helicobacter pylori infection in patients with hemophilia or von Willebrand's syndrome.
BACKGROUND
Many episodes of bleeding in the upper gastrointestinal tract are caused by Helicobacter pylori infection. Because these episodes present a life-threatening complication in patients with bleeding disorders, we prospectively investigated the prevalence of H. pylori infection in patients with hemophilia A or B and with the von Willebrand syndrome.


METHODS
Seventy patients (54 men, 16 women, ages 40 +/- 11 years) and 100 age-related volunteers (63 men, 37 women, ages 39 +/- 9 years) were tested for H. pylori infection using the 13C urea breath test. Fifty-four patients with hemophilia and 16 patients with von Willebrand syndrome participated.


RESULTS
Thirty-three (33%) of the controls and 24 (34.3%) of the patients showed positive 13C urea breath tests (p = .97). Nineteen (35.2%) patients with hemophilia and 5 (31.3%) patients with von Willebrand syndrome were positive for H. pylori. History of dyspeptic symptoms (28% vs. 26%) were not different in patients and controls (p = .91). Gastric ulcers (20% vs. 5%) and duodenal ulcers (7% vs. 5%) were diagnosed more often in patients with bleeding disorders. Fourteen of the patients (20%), but none of the controls had a history of gastrointestinal bleeding (p < .001).


CONCLUSIONS
The rate of H. pylori infection and dyspepsia in patients with bleeding disorders is similar to the prevalence in the normal population. Due to increased bleeding complications, H. pylori screening and therapy appears mandatory in patients with bleeding disorders.
Braden
B
B
Medical Department II, Johann Wolfgang Goethe-Universität, Frankfurt/Main, Germany. Braden@em.uni-frankfurt.de
Wenke
A
A
Karich
H J
HJ
Dietrich
C F
CF
Scharrer
I
I
Caspary
W F
WF
Lembcke
B
B
D000328:Adult; D001944:Breath Tests; D004415:Dyspepsia / Q000150:complications / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D016480:Helicobacter pylori; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014508:Urea / Q000032:analysis; D014842:von Willebrand Diseases / Q000150:complications*
D014508:Urea