Association of Presenting Symptoms With Abnormal Laboratory Values for Vector-Borne Illness - Experience in an Urban Gastroenterology Practice
| Autor: | Kristen H Reynolds, Jessica Ye, Michael D. Erdman, Farshid Sam Rahbar, B. Robert Mozayeni, Emily Blodget, Niloofar Kossari |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
vector-borne illness
medicine.medical_specialty malabsorption lcsh:Medicine small intestinal bacterial overgrowth tick-borne Internal medicine Small intestinal bacterial overgrowth medicine Medical history Original Research business.industry lcsh:R Heartburn General Medicine Odds ratio sibo medicine.disease Indigestion lyme disease functional bowel disorders bloating Food intolerance digestive symptoms gastrointestinal symptoms Review of systems Vomiting medicine.symptom business |
| Zdroj: | J Patient Cent Res Rev Journal of Patient-Centered Research and Reviews, Vol 8, Iss 1, Pp 39-47 (2021) |
| ISSN: | 2330-0698 |
| Popis: | Background: In the clinical setting, it is not common practice to consider a vector bite, such as from a tick or flea, to be a contributing factor to chronic digestive symptoms. This article investigates associations we have observed among symptomatic patients and positive blood tests for vector-borne illness (VBI). Methods: Patients who visited an urban gastroenterology clinic over a 3-year period were retrospectively reviewed. A total of 270 patients presenting with a constellation of digestive symptoms — and who had no apparent digestive pathology and reported no prior diagnosis or treatments for VBI — were analyzed. Before the initial visit, all patients completed a review of systems medical history form, which comprised 19 gastrointestinal (GI) symptoms and 73 non-GI-related symptoms and conditions. Patients were tested for small intestinal bacterial overgrowth (SIBO) by lactulose breath test. VBI (babesiosis, ehrlichiosis, anaplasmosis, bartonellosis, borreliosis) was established using 1 or more of several blood tests. Odds ratio (OR) analysis determined associations between exposure to VBI, SIBO, and presenting symptoms/conditions. Two age groups (≤ 35 years and ≥ 36 years) were studied using Cochran-Mantel-Haenszel stratum-based test. Results: A higher OR (2.03, 95% CI: 1.5–3.6) was found between patients with ≥ 3 digestive symptoms and positive blood tests for ≥ 1 VBI. Five of the 19 GI symptoms were independently associated with VBI-positive samples: food intolerance, indigestion, nausea/vomiting, constipation, and heartburn. A similar association in patients with ≥ 3 non-GI symptoms (OR: 2.83, 95% CI: 1.3–6.4) was observed. Five of the 73 non-GI symptoms/conditions were independently associated with VBI-positive samples: chest pain, shortness of breath, extremity or joint pain, anxiety, and night sweats. Having ≥3 of any digestive or nondigestive symptoms generated significant relative risk of being VBI-positive. Presence of SIBO alone did not identify significant relative risk for a VBI, and age was not a confounder. Conclusions: Findings revealed an association between positive blood tests for vector-borne illness and chronically symptomatic patients regardless of whether symptoms were digestive or nondigestive. The manifestation of 3 or more gastrointestinal and/or extraintestinal symptoms should raise suspicion for a VBI. |
| Databáze: | OpenAIRE |
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