Peptic Ulcer in the Hæmophiliac and Its Relation to Gastrointestinal Bleeding

Carron, D. B.; Boon, T.H.; Walker, Frank C.

doi:10.1016/s0140-6736(65)90569-6

Cited by 20 publications

(16 citation statements)

References 17 publications

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“…In haemophilia, the bleeding occurred in the majority of patients with peptic ulcers. Similar findings were reported by other authors who observed upper gastrointestinal bleeding in all the patients with confirmed ulcers [23]. Bleeding from the peptic ulcer in haemophilia patients was the predominant and frequently the only one manifestation of peptic ulcer disease [13,22,23].…”

Section: Discussionsupporting

confidence: 89%

Helicobacter pylori infection in patients with haemophilia in Poland: prevalence and risk of upper gastrointestinal bleeding

Szczepanik¹,

Zaleska²,

Wiszniewski³

et al. 2005

Haemophilia

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Infection with Helicobacter pylori is the main aetiological factor for erosive gastritis and duodenal or gastric peptic ulcers often complicated with life-threatening bleeding in patients with coagulation disorders. The aim of this prospective study was to evaluate the prevalence of Helicobacter pylori infection in haemophilia patients, and to assess the risk of gastrointestinal bleeding associated with this infection. From 2000 to 2002, 146 patients with haemophilia (129, haemophilia A; 13, haemophilia B), mean age, 39.9 years (+/-7.3), were investigated for H. pylori infection using IgG and IgA latex serological test. The control group included 100 men with no coagulation disorders, mean age, 40.9 years (+/-9.2). For 72 (49.3%) patients with haemophilia and 39 controls (39.0%) serological tests were positive indicating the presence of H. pylori infection (P =0.1112). A history of gastrointestinal bleeding was reported in 46 patients (31.5%) with haemophilia and in two control group patients (2.0%) (P < 0.0001). Gastrointestinal bleeding was significantly more frequent in patients with haemophilia infected with H. pylori (33/46; 71.7%) than in patients with no H. pylori infection (13/46; 28.3%; P = 0.0002). In conclusion, the prevalence of H. pylori infection in haemophilic patients in Poland is comparable with that in patients with no coagulation disorders. Helicobacter pylori infection is a risk factor for duodenal and gastric ulcer bleeding in haemophilia patients. In view of the high frequency of upper gastrointestinal bleeding associated with H. pylori infection, we believe that screening and eradication therapy are appropriate in haemophilia patients.

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Section: Discussionsupporting

confidence: 89%

Helicobacter pylori infection in patients with haemophilia in Poland: prevalence and risk of upper gastrointestinal bleeding

Szczepanik¹,

Zaleska²,

Wiszniewski³

et al. 2005

Haemophilia

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“…Since otherwise trivial local inciting events might be expected to result in more severe or prolonged bleeding in the setting of an underlying coagulopathy, it is not surprising that UGI bleeding is more common in PWH than in the general population [11][12][13]21,22]. Of PWH, 10-25% experience episodes, of GI bleeding [6,11,12,[23][24][25][26] and recurrent bleeding is common.…”

Section: Discussionmentioning

confidence: 99%

“…Persons with haemophilia (PWH) commonly experience gastrointestinal bleeding [11][12][13], but the incidence of UGI bleeding and the relationship of UGI bleeding to NSAIDs in this population are unknown. The primary purpose of this study was to determine the incidence of UGI bleeding and its relationship to the use of the tNSAIDs and coxibs, considering Heliobacter pylori and other known or likely risk factors, in the patients enrolled in the second Multicenter Hemophilia Cohort Study (MHCS-II).…”

Section: Introductionmentioning

confidence: 99%

Upper gastrointestinal bleeding in haemophiliacs: incidence and relation to use of non‐steroidal anti‐inflammatory drugs

et al. 2007

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This multicentre study sought to estimate the incidence of upper gastrointestinal (UGI) bleeding in haemophiliacs and its relationship to use of non-steroidal anti-inflammatory drugs (NSAIDs). Cox models were used to estimate relative hazards (RH) with 95% confidence intervals (CI) for postulated risk factors. Conditional logistic regression and stored sera were used to assess UGI bleeding risk with Heliobacter pylori seropositivity in cases compared with closely matched controls. During a mean of 17.4 months (range 2-34), 2285 participants, ages 13-89 (mean 36.5) were followed for 3309 person-years (py). Forty-two experienced a UGI bleeding event (incidence 1.3 per 100 py), most from ulcer (11), gastritis (four), varices (five) and Mallory Weiss tears (eight). RH was significantly increased with traditional NSAID use for <1 month (OR: 3.66; 95% CI: 1.1-11.9), but not with coxibs use. RH was significantly and independently increased with age >46 years (3.5; 95% CI: 1.1-10.6) and hepatic decompensation (4.4; 95% CI: 1.7-11.6). Likelihood of bleeding was substantially but not significantly increased (OR: 4.6; 95% CI: 0.3-83.9) with H. pylori seropositivity. These findings suggest that coxibs are a safer alternative than traditional NSAIDs in the treatment of haemophilic arthropathy.

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“…Die H/~ufigkeit einer hdmorrhaqischen Diathese als Ursache einer Blutung aus dem oberen Gastrointestinal-Trakt wurde im klinischen Krankengut mit 4--5 °/o [19,36] Zahlen zweier Arbeitsgruppen [6,11] zeigen, dal~ bei Patienten mit H/imophilie in fiber 20 °/0 der F/file mit dem Auftreten einer gastrointestinalen Blutung zu rechnen ist. Ein Ulcus war bei 29 der hier erfal]ten 46 F&lle rSntgenologisch nachweisbar.…”

Section: Hsu/igkeitunclassified

“…Die It/imophiliekranken haben somit eine hohe Ulcusrate. Die Ulcera neigen in extremem Ma6e zu Rezidivblutungen [6,11,35,39]. Bei 647 aus der Literatur zusammengestellten F/illen von Ur£mie [7,14,25,28,33,40] …”

Section: Hsu/igkeitunclassified

83. Blutungen aus dem Magen-Darm-Trakt ? Internistisches Referat

Hp¹

1974

Langenbecks Arch Chiv

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Summary.A serious clotting defect can be recognized in 15°/o of patients with upper gastrointestinal bleeding. The incidence of gastrointestinal bleeding is about 200/0 in hemophilia and 10°/o in uremia. The incidence of peptic ulcers in patients on hemodialysis is around 500/0 . Our own investigations proved that a severe coagulation defect was a contributory cause of bleeding in 10 out of 30 patients with esophageal varices and in 18 out of 52 cases of bleeding stress lesions. The therapy consists in substitution of the depleted clotting components. [19,36] nnd im Obduktionsgut mit 8--11 °/o [3, 8, 21] angegeben. In diesen Fallen

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Peptic Ulcer in the Hæmophiliac and Its Relation to Gastrointestinal Bleeding

Cited by 20 publications

References 17 publications

Helicobacter pylori infection in patients with haemophilia in Poland: prevalence and risk of upper gastrointestinal bleeding

Helicobacter pylori infection in patients with haemophilia in Poland: prevalence and risk of upper gastrointestinal bleeding

Upper gastrointestinal bleeding in haemophiliacs: incidence and relation to use of non‐steroidal anti‐inflammatory drugs

83. Blutungen aus dem Magen-Darm-Trakt ? Internistisches Referat

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