A POSSIBLE ASSOCIATION BETWEEN H. PYLORI INFECTION AND EXTRA-GASTRIC PATHOLOGY - A CASE REPORT.

Introduction. A frequent problem in daily practice that gastroenterologists have to confront with is Helicobacter pylori infection. The stomach is where H. pylori infection naturally occurs, this bacterium being the cause of pathologies such as gastritis, peptic ulcer, MALT lymphoma and stomach cancer. Additionally, there is proof connecting the bacteria to a number of extra-gastric pathologies. Case report. We report the case of a 55 year old patient from a rural area, with no significant heredocollateral antecedents, with a history of cardiovascular pathology (Hypertension and Chronic Coronary Syndrome) investigated for digestive bleeding (intermitent hematochezia), important physical astenia, loss of appetite, diffuse abdominal pain and weight loss (5 kg/one month). Clinical investigation reveals: good general condition, pale teguments and mucous membranes, koilonychia, tachycardia (115 bpm), decreased left-based vesicular murmur. Laboratory examinations reveal hipochromic microcyte anemia, negative viral and autoimmunity markers, normal kidney function, normal tumor markers, except increased carcinoembryonic antigen (CEA) (9,2 ng/ml). An upper digestive endoscopy is being performed, which reveals anthral gastritis, a spastic pylorus and a congestive bulb with a 1,5 cm diameter ulcer located on the anterior wall, Forrest III. Due to its position and difficulty to reach, no biopsy for H. pylori was taken from the ulcer, however, the IgG H. pylori antibodies and fecal antigen were positive, which determined the initiation of treatment in order to eradicate the infection. Colonoscopy shows an isolated ulcerated lesion, easily bleeding when touched with the colonoscope, but with no active bleeding focus, located in the right colon. Pathology of the biopsy material was suggestive for adenocarcinoma, which determined the patient's redirection to the surgery clinic for the surgical treatment to be performed. Discussion. The particularity of the case is the association of a duodenal ulcer H. pylori positive with right colon neoplasm, but without any other declared risk factors, H. pylori being a recognized class of human carcinogens and there are numerous studies in literature that have looked into the connection between H. pylori infection and colorectal cancer. Conclusion. Finding out how this organism plays a role in various pathologies can be aided by eradicating this infection and reevaluating individuals who have recovered from it. It is yet unclear what the underline pathophysiology of this association is, so more fundamental research in this area is needed. [ABSTRACT FROM AUTHOR]