Correction to: The impact of helicobacter pylori eradication on platelet counts of adult patients with idiopathic thrombocytopenic purpura

BackgroundIdiopathic (immune) thrombocytopenic purpura (ITP) is an acquired disorder characterized by autoantibodies against platelet membrane antigens. Several studies found an association between Helicobacter Pylori infection and the incidence of ITP. So far, It is still unclear whether H. pylori eradication will increase platelet counts in adult ITP patients. We conduct this study to investigate platelet recovery in ITP patients after H. pylori eradication.MethodsThis is a prospective study. The diagnostic criterion for Idiopathic thrombocytopenic purpura is: isolated thrombocytopenia, with no evidence of any underlying causes like drugs, TTP, SLE, hepatitis, HIV,CLL and… etc. We examined blood smears of all patients. We have diagnosed Helicobacter pylori infection by histological examination of several biopsies obtained from stomach and duodenum by esophagogastroduodenoscopy (EGD). If EGD was not applicable due to patient’s poor situation or platelet count, H.pylori infection was diagnosed by the positivity of serum antibodies or respiratory urease test. We treated infected patients with triple therapy (omeprazole 40 mg once daily, amoxicillin 1000 mg twice daily and clarithromycin 500 mg twice daily) for 14 days. Uninfected patients did not receive any treatment. We did platelet quantification at the beginning of the study, at the end of the first month, at the end of the third month and at the end of the sixth month.ResultsThis study involved 50 patients with chronic ITP, 29 males (58%) and 21 females (42%). Participants ages range between18 and 51 years (mean age = 28.60 years). We diagnosed H. pylori in 36 patients (72%), who were treated with triple therapy. At the end of the sixth month, 10 of them (27.77%) showed complete response, and 18 of them (50%) showed partial response. The 14 uninfected patients, who did not receive any treatment, did not show neither complete nor partial response. Patient sex and age were not associated with achieving response, while baseline platelet count and H.pylori infection did.ConclusionHelicobacter pylori eradication significantly increases platelet counts in adult ITP patients.

Objective To assess the impact of Helicobacter pylori (Hp) eradication on the patient's quality of life. Background Functional dyspepsia (FD) is a common clinical problem that is seldom life-threatening, but impairs health-related quality of life. It was found that Hp gastritis was present in 30–60% of patients with FD. Patients and methods This study was carried out on 318 patients (18–55 years old) who fulfilled the ROME III diagnostic criteria for FD. They attended the Munshaat Sultan Family Health Center, Menouf district, Menoufia, Egypt, during the period from January 2013 to January 2014. Patients were invited to complete a baseline quality of life in patients with reflux and dyspepsia questionnaire (QOLRAD), and were classified as Hp+ and Hp− by Hp stool antigen testing. Hp+ patients received a 1-week course of Hp eradication. Hp+ and Hp− patients received a 4-week course of proton pump inhibitors (PPIs), prokinetics, and lifestyle modification, followed by on-demand therapy (PPIs, prokinetics) and lifestyle modification for 6 months. Reassessment of the patient's quality of life using the QOLRAD questionnaire by the two groups was performed 6 weeks and 6 months from the start of the treatment. Results Out of 318 patients with FD attended Munshaat Sultan Family Health Center a006Ed fulfilled ROME III criteria the percentage of Hp was 41.8%. QOLRAD were significantly lower in Hp+ than Hp− patients (P Conclusion In patients with FD, Hp eradication in infected patients and PPIs and prokinetics in Hp− patients reversed low QOL scores and improved global QOL during the 6-month follow-up period. Thus, we recommend the test and treat strategy for Hp for the management of patients with FD attending primary care clinics.

Background: Invasive therapies are often needed for sufferers with chronic liver diseases (CLDs). Thrombocytopenia is common hematological abnormality in CLD sufferers. In immune thrombocytopenic purpura (ITP), Helicobacter pylori (HP) infection is linked to a low platelet count, whereas HP eradication is associated to an increase in platelet count. In Egypt, the most common trigger of CLD is infection with the hepatitis C virus. In Egypt HP is common infection happens at a young age. Aim of the work: The impact of Helicobacter pylori eradication on platelet count in HCV-related CLD patients with thrombocytopenia. Patients and methods: A prospective study of 100 patients divided to HP positive and HP negative. Sufferers that checked positive for HP have been given treatment to eliminate the virus. HP eradication was evaluated using a stool test for Helicobacter pylori antigen 6 weeks following the treatment was completed. Platelet counts were used to assess the success of HP eradication after 1, 3, 6, and 9 months of follow-up. Results: HP infection prevalence among HCV patients 65% (65/100) versus 35% (35/100) HP negative. Eradication in HP positive patients after treatment were 46 patients (70.8%) and 19 patients (29.2%) not eradicate. platelets response after HP therapy there were 14 patients (21.5%) with complete response, 20 patients (30.8%) had a partial response, while 31 had no response (47.7%){12 eradicated and 19 not eradicated} Conclusion: Successfully eradicating H. pylori can have an impact on platelet recovery and platelet count maintenance in patients with chronic HCV-infected thrombocytopenia

Background: At present, some evidence supports the role of Helicobacter pylori eradication in treating childhood immune thrombocytopenia (ITP). Objectives: This study was designed to investigate the association between H. pylori eradication and platelet count in children with acute ITP. Methods: Thirty children with a diagnosis of acute ITP and H. pylori infection were studied. This randomized and controlled study was done in Amir-Kabir Hospital, Arak, Iran. Patients were randomly allocated 1:1 to standard ITP and H. pylori treatments or standard ITP treatment. For 6 months, studied subjects had monthly follow-ups. Results: The mean ± standard deviation (SD) age was 11 years with a majority of females (67.9 % vs. 32.1 %). The mean platelet count was 16.93 ± 10.1 (109/L) in the ITP and H. pylori therapy group, and15.0 ± 3.8 (109/L) in the ITP therapy group at the baseline. After 1 week of treatment, mean platelet counts increased to 136.5 ± 55.20 and 124.0 ± 45.70 in the two groups, respectively (109/L). The differences between the two groups were not statistically significant at other time intervals. Children that received ITP and H. pylori therapies had a higher rate of gastrointestinal symptoms (P < 0.01). Conclusions: Our findings suggest that H. pylori eradication did not significantly affect the platelet count compared to standard ITP therapy in children with acute ITP.

Infectious agents and human immune diseases: Lessons from Helicobacter pylori

Immune Thrombocytopenia during Childhood: New Approaches to Classification and Management

Idiopathic Thrombocytopenic Purpura

Idiopathic thrombocytopenia and Helicobacter pylori infection: platelet count increase and early eradication therapy.

Improvement of Platelet Count after Helicobacter Pylori Screening and Eradication in Immune Thrombocytopenia Patients: A Randomized Open-Label Study

The spleen dictates platelet destruction, anti-platelet antibody production, and lymphocyte distribution patterns in a murine model of immune thrombocytopenia.

Since gastric cancers (GCs) detected after Helicobacter pylori (HP) eradication present with different morphological characteristics from conventional HP-positive GCs, delayed detection of early-stage GCs may be observed. This study aimed to investigate the clinical impact of HP eradication on diagnosing GC during screening endoscopy. Eleven health checkup institutions in Japan participated in the present study. All GC cases newly diagnosed by screening endoscopy between January 2016 and December 2020 were included. After propensity score matching, multivariable regression analysis was performed to estimate the effect of HP eradication on deep tumor invasion among HP-eradicated and HP-positive GC cases. A total of 231 patients with GCs (134 HP-eradicated and 97 HP-positive cases) were enrolled. After propensity score matching, there were 81 cases in each group. The distribution of the depth of tumor invasion (pT1a, pT1b1, pT1b2, and pT2) between the HP-eradicated group and HP-positive group was similar (p = 0.82). In the propensity analysis, with HP-positive as the reference value, HP eradication was not significantly associated with T1b-T4-GCs and T1b2-T4-GCs, with odds ratios (95% confidence intervals) of 1.16 (0.48-2.81) and 1.16 (0.42-3.19), respectively. HP eradication does not adversely affect the clinical course of GCs, supporting the recommendation of HP eradication in screening programs to reduce the total number of GC cases without delaying diagnosis.

Forty-nine children (30 boys and 19 girls) with idiopathic thrombocytopenic purpura (ITP) seen at King Khalid University Hospital (KKUH) Riyadh, during a 7-1/2 year period were retrospectively reviewed with regard to their clinical characteristics, management, and outcome. The age of onset of the disease ranged from 8 months to 11 years with a mean of 4.26 years. Twenty-seven cases presented as acute ITP while 22 cases presented as chronic ITP. The clinicopathological features and response to treatment of the cases were essentially similar to findings in other parts of the world. In a search for a predictor of chronic disease, the platelet counts at four weeks and three months after diagnosis were found to be a significant factor for prediction of chronicity of ITP. If the platelet counts are less than 100x10(9)/L during these periods, the risk of chronic ITP is increased and vice versa. There was, however, no correlation in our patients between duration of symptoms prior to presentation and outcome of the disease as has been reported by investigators in Europe and Australia.

SARS-CoV-2 vaccination in pediatric patients with immune thrombocytopenia.

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 x 10(9)/L within the medication-free screening month were enrolled (n = 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 x 10(9)/L 24 weeks after treatment, together with an increase in the platelet count >30 x 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 = 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 = 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.

Helicobacter pylori infection and childhood idiopathic thrombocytopenic purpura.