Poor platelet Count Response to Helicobacter pylori Eradication in Patients with severe Idiopathic Thrombocytopenic Purpura (original) (raw)
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Helicobacter pylori eradication can induce platelet recovery in idiopathic thrombocytopenic purpura
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Archives of Internal Medicine, 2004
Background: A relationship between Helicobacter pylori infection and idiopathic thrombocytopenic purpura (ITP) has previously been reported. We determined the prevalence of H pylori infection in Japanese patients with chronic ITP and the effect of its eradication on platelet count. Methods: The study population comprised 53 Japanese adults with chronic ITP and a platelet count of less than 100 ϫ 10 3 /µL. A 13 C-urea breath test was performed to determine H pylori infection status. Those patients who were H pylori positive gave written informed consent and received eradication therapy. The effect of H pylori eradication on platelet count was evaluated up to 6 months after therapy. Clinical parameters were compared between responders to the therapy (increase in platelet count) and nonresponders, as well as between H pylori-positive and-negative patients. Results: Of the 53 patients with chronic ITP in the study, 39 (74%) were H pylori positive. Of the 32 infected patients who received treatment, H pylori was successfully eradicated in 27 patients (84%). In 10 (37%) of these patients, this resulted in a favorable platelet response. A partial response was seen in 5 additional patients (19%). A significant (PϽ.001) increase in platelet count was demonstrated in patients in whom H pylori was successfully eradicated but not in patients who were unsuccessfully treated or in untreated patients. Current corticosteroid therapy was reported more often in nonresponders than in responders. Conclusion: Eradication of H pylori may prove effective in increasing platelet count in H pylori-positive patients with chronic ITP.
The American Journal of Medicine, 2005
To investigate the relation between Helicobacter pylori infection and the clinical features of idiopathic thrombocytopenic purpura (ITP), and to examine the effects of H. pylori eradication on platelet counts. METHODS: A 13 C urea breath test for H. pylori infection was performed in a cohort of 137 consecutive patients with ITP. Patients who tested positive received standard eradication therapy if their platelet count was Ͻ50 ϫ 10 9 /L or if they had symptoms of dyspepsia. RESULTS: H. pylori infection was detected in 64 patients (47%), and was not associated with dyspepsia or other clinical or laboratory features. Eradication therapy was successfully administered to 52 patients. Platelet responses were observed in 17 (33%) of these patients, which lasted for more than 1 year in 11 patients. Duration of ITP was shorter among responders than nonresponders. Only one response was observed among patients with severe thrombocytopenia (platelet count Ͻ30 ϫ 10 9 /L). CONCLUSION: The prevalence of H. pylori infection in patients with ITP is similar to that found in the general population. Infection is not associated with distinctive features of the disease. H. pylori eradication may improve the platelet counts in adults in whom the ITP is of recent onset and in those with less severe degrees of thrombocytopenia, but was not effective in patients with chronic severe ITP.
Platelets, 2006
The prevalence of Helicobacter pylori infection and the effect of its eradication on platelet count in 95 Iranian patients with chronic refractory autoimmune thrombocytopenic purpura (CRITP) was investigated. 69 of 95 patients were infected with H.pylori (72.6%). H.pylori eradication was obtained in 69 infected CRITP patients who were not in remission and had platelet count below 100×10 9 at the time of infection assessment. 4 patients failed to eradicate of H.pylori. During follow-up (median 22.5 months). 3 of 33 of responsive patients relapsed after 14 months of eradication. 30 of 65 H.pylori-eradicated patients (46%) showed a significant increase in platelet count accompanied by a significant decrease of platelet-associated immunoglobulin G (IgG). In forteen patients without H.pylori infection, platelet counts did not significantly increase with the same treatment. On the other hand, eradication therapy did not affect platelet counts in 6 patients with gastric ulcer. This response was maintained in all responding patients throughout the follow up period. The assessment of H.pylori infection and its eradication shoud be attempted in CRITP as this approach could be an effective strategy, at least for some of these patients.
Mediterranean Journal of Hematology and Infectious Diseases, 2012
Idiopathic thrombocytopenic purpura characterized by auto antibody-mediated platelet destruction. Although the main cause of ITP remains unclear, but its relationship with some infection was demonstrated. In recent years, many studies have demonstrated improvement of platelet counts in ITP patients after treating Helicobacter pylori infection. The aim of this study was to investigate the effects of eradication on platelet count response in Iranian ITP patients. A total of 26 patients diagnosed with both ITP and platelet counts were less than 100× Breath Test and serum H. pylori eradicate H. pylori infection. These patients followed for six months. Prevalence of H. pylori was 67.3%. patients, 15 (57.7%) exhibited a complete response (CR) and not find partial responders. There was responders and non-responders patients ( and all non-responders had platelet Results of this study revealed that counts in ITP patients especially with mild thrombocytopenia and support routine detection and treatment of H. pylori infection in ITP pa infection.
American Journal of Hematology, 2008
Several recent studies have suggested that an association exists between Helicobacter pylori (HP) eradication and improvement in platelet count in a significant proportion of patients with idiopathic thrombocytopenic purpura (ITP). In this controlled study, we prospectively examined adult patients with chronic ITP for HP infection, and assessed the effect of HP eradication on platelet count. One hundred forty-two consecutive Iranian patients with chronic ITP were assessed. Those who met the criteria and had platelet counts >30 3 10 9 /L within the medication-free screening month were enrolled (n 5 129; 66 females; mean age, 29.2 ± 7.0 years). HP-positive patients received a 2-week course of triple HP eradication therapy (i.e., amoxicillin, clarithromycin, and omeprazole) and were followed for 48 weeks. An ITP response was defined as a platelet count of >100 3 10 9 /L 24 weeks after treatment, together with an increase in the platelet count >30 3 10 9 /L over the baseline value. HP infection was detected in 79 (61%) patients. HP-positive patients were significantly older than HP-negative subjects (P 5 0.018). HP eradication was successful in 87% (62/71) of those who completed the eradication therapy. Whereas 48% (30/62) of HP-eradicated patients showed an ITP response, no HP-negative patient had an ITP response. The ITP response persisted for 48 weeks in 93% (28/30) of the responders. The ITP responders had a shorter disease duration than the nonresponders (P 5 0.002). The management of mild-to-moderate chronic ITP in Iranian patients, especially those with a recent onset of disease, should include an investigation for and eradication of infection with HP.